Business Analyst III - Medicare Claims Configuration
Company Name:
Centene
## Description
Joining Centene means you'll be surrounded by colleagues who are dedicated to meeting their own high standards, to inspiring their teammates and to making a positive impact on under-insured and uninsured individuals.
As part of the Claims Configuration team, you will have responsibility for the claims payment system's configuration to ensure timely and accurate claims payment. The Business Analyst in this role will gain exposure to all facets of Centene's business operations and assist with implementations and expansions in his/her Medicare and Medicaid markets.
Position Purpose : Perform various analysis and interpretation to link business needs and objectives for assigned function.
Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems
Identify and analyze user requirements, procedures, and problems to improve existing processes
Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations
Identify ways to enhance performance management and operational reports related to new business implementation processes
Coordinate with various business units and departments in the development and delivery of training programs
Develop, share, and incorporate organizational best practices into business applications
Diagnose problems and identify opportunities for process redesign and improvement
Formulate and update departmental policies and procedures
Serve as the subject matter expert on the assigned function product to ensure operational performance.
Ability to travel (Minimal travel is required)
## Qualifications
Education/
Experience:
Bachelor's degree in related field or equivalent experience.
4
years of business process or data analysis experience (i.e. documenting business process, gathering requirements), preferably in healthcare.
Advanced knowledge of Microsoft Applications, including Excel and Access.
Experience in benefits, pricing, contracting or claims and knowledge of provider reimbursement methodologies.
Preferred
Experience:
Medicare
Ability to read, interpret, and translate contracts into requirements for configuration.
UAT testing.
Tier 2 problem solving and the ability to identify root cause of issues to increase auto adjudication rates, internal quality scores, and ensure other metrics are within acceptable ranges.
Project management and ability to lead meetings.
Working knowledge of managed care information or claims payment systems
## Job
Job: Data Analytics
Primary Location: USA-Missouri-Clayton
Organization: Claims Operations
Schedule: Full-time
Req ID: 1004549Estimated Salary: $20 to $28 per hour based on qualifications.
Centene
## Description
Joining Centene means you'll be surrounded by colleagues who are dedicated to meeting their own high standards, to inspiring their teammates and to making a positive impact on under-insured and uninsured individuals.
As part of the Claims Configuration team, you will have responsibility for the claims payment system's configuration to ensure timely and accurate claims payment. The Business Analyst in this role will gain exposure to all facets of Centene's business operations and assist with implementations and expansions in his/her Medicare and Medicaid markets.
Position Purpose : Perform various analysis and interpretation to link business needs and objectives for assigned function.
Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems
Identify and analyze user requirements, procedures, and problems to improve existing processes
Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations
Identify ways to enhance performance management and operational reports related to new business implementation processes
Coordinate with various business units and departments in the development and delivery of training programs
Develop, share, and incorporate organizational best practices into business applications
Diagnose problems and identify opportunities for process redesign and improvement
Formulate and update departmental policies and procedures
Serve as the subject matter expert on the assigned function product to ensure operational performance.
Ability to travel (Minimal travel is required)
## Qualifications
Education/
Experience:
Bachelor's degree in related field or equivalent experience.
4
years of business process or data analysis experience (i.e. documenting business process, gathering requirements), preferably in healthcare.
Advanced knowledge of Microsoft Applications, including Excel and Access.
Experience in benefits, pricing, contracting or claims and knowledge of provider reimbursement methodologies.
Preferred
Experience:
Medicare
Ability to read, interpret, and translate contracts into requirements for configuration.
UAT testing.
Tier 2 problem solving and the ability to identify root cause of issues to increase auto adjudication rates, internal quality scores, and ensure other metrics are within acceptable ranges.
Project management and ability to lead meetings.
Working knowledge of managed care information or claims payment systems
## Job
Job: Data Analytics
Primary Location: USA-Missouri-Clayton
Organization: Claims Operations
Schedule: Full-time
Req ID: 1004549Estimated Salary: $20 to $28 per hour based on qualifications.
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