skip to main content

Important Notice

It appears you are using an older version of your browser. While some functions will be available, Delaware JobLink works best with a modern browser such as the ones provided by:

Please download and install the latest version of the browser of your choice. We apologize for any inconvenience.



Business Analyst I-III - PS24940

Click the Facebook, Google+ or LinkedIn icons to share this job with your friends or contacts. Click the Twitter icon to tweet this job to your followers. Click the link button to view the URL of the job, which then can be copied and pasted into an e-mail or other document.

Job Details
Job Order Number
JC145580599
Company Name
Anthem
Physical Address

Wilmington, DE 19806
Job Description

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

Level I

+ 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.

Level II

+ 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

Level III

+ 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.


To view full details and how to apply, please login or create a Job Seeker account.