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Our client, a leading healthcare insurance organization, is seeking a contract Business Analyst to join their team. This individual will support critical claims operations initiatives, process improvement efforts, and cross-functional projects focused on enhancing the member experience and driving operational efficiency.
About the Job:
- Analyze and resolve medical claims processing issues and inquiries
- Perform root cause analysis to identify operational challenges and implement corrective actions
- Partner with internal teams and external health plans to resolve claims discrepancies
- Research incorrectly processed claims and coordinate solutions to ensure accurate resolution
- Identify opportunities to improve operational processes through technology, automation, and data analysis
- Support process improvement and project management initiatives across the organization
- Pull, analyze, and summarize large data sets to support business decisions
- Document business processes, workflows, and operational procedures
- Serve as a subject matter expert for claims operations in meetings, projects, and company initiatives
- Collaborate with cross-functional stakeholders to enhance claims processing efficiency and accuracy
About You:
- 4+ years of experience in medical claims processing, claims adjusting, healthcare administration, or a related healthcare operations environment
- Experience supporting automation, reporting, or technology-driven process improvements is highly preferred
- Experience working with medical billing and coding, including ICD-10, CPT, and HCPCS codes
- Advanced Microsoft Excel skills with the ability to analyze and manipulate large data sets
- Working knowledge of SQL and Microsoft Access
- Strong understanding of medical claims processing and healthcare operations
- Strong analytical and problem-solving abilities with a passion for process improvement
- Excellent written and verbal communication skills
- Ability to manage multiple priorities and meet deadlines in a fast-paced environment
This contract position is expected to last at least six months with the possibility of converting to a permanent role. It will work hybrid schedule of three days onsite at the organization’s Philadelphia office and two days remote. It is paying up to $48/hour depending on experience. If you’re a healthcare operations professional who enjoys leveraging data, technology, and process improvement to solve complex claims challenges, we’d love to hear from you. Please apply today with a Microsoft Word version of your resume.
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