Business Analyst I-III - PS24940
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Wilmington, DE 19806
Business Analyst I-III – PS24940
Location: United States
Requisition #: PS24940
Post Date: Sep 04, 2019
Your Talent. Our Vision . At Amerigroup , a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals,it’s a powerful combination. It’s the foundation upon which we’re creating greater access to care for our members, greater value for our customers and greater health for our communities. Join us and together we will drive the future of health care .
This is an exceptional opportunity to do innovative work that means more to you and those we serve.
Location: Remote; Virginia Beach, VA office preferred.
The Business Analyst I-III is responsible for serving as the liaison between the business and IT in translating claim requirements as it pertains to overpayment concepts. The analyst will also serve as a liaison between Claims Payment Integrity and internal business partners, such as Health Plan Operations, Reimbursement Methodology, and Claims Configuration, etc. to ensure overpayment concepts are valid and claims identified are accurate. The analyst will also perform other duties, such as working monthly overpayment concepts to ensure continued accuracy and timely recoupment for GBD claims.
Primary duties may include, but are not limited to:
+ Analyzes complex end user needs to determine optimal means of meeting those needs.
+ Determines specific business application software requirements to address complex business needs.
+ Develops project plans and identifies and coordinates resources, involving those outside the unit.
+ Works with programming staff to ensure requirements will be incorporated into system design and testing.
+ Acts as a resource to users of the software to address questions/issues.
+ May provide direction and guidance to team members and serves as an expert for the team
+ Requires a HS diploma or GED, 5 years of related health care experience that includes work flow design, data analysis, and/or systems automation and testing; or any combination of education and experience, which would provide an equivalent background.
+ BA/BS degree preferred.
+ Requires a BS/BA degree, 3-5 years of business analysis experience that includes knowledge of systems capabilities and business operations; or any combination of education and experienced, which would provide an equivalent background
+ Requires a BS/BA degree, 5-7 years of business analysis experience that includes knowledge of systems capabilities and business operations; or any combination of education and experienced, which would provide an equivalent background
Requirements and preferences for all levels
+ Must be a self-starter
+ Strong communication skills required
+ Ability to quickly establish and leverage networks required
+ Experience as a Reimbursement Policy expert desired
+ Coding / Billing experience preferred
+ SQL or Query experience desired
+ Experience with health plan operations preferred
+ Network Management experience preferred
+ Contracting experience preferred
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.