Business Analyst - Claims
Company: Sunshine State Health Plan
Location: Hialeah
Posted on: October 10, 2024
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Job Description:
You could be the one who changes everything for our 28 million
members. Centene is transforming the health of our communities, one
person at a time. As a diversified, national organization, you'll
have access to competitive benefits including a fresh perspective
on workplace flexibility.
Qualified candidates must reside in Florida.
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 new
systems.
Identify and analyze user requirements, procedures, and problems to
improve existing processes.
Perform detailed analysis on assigned projects, recommend potential
business solutions and assist with implementation.
Identify ways to enhance performance management and operational
reports related to new business implementation processes.
Develop and incorporate organizational best practices into business
applications.
Lead problem solving and coordination efforts between various
business units.
Assist with formulating and updating departmental policies and
procedures.
Encounters: Bachelor's degree in related field or equivalent
experience. 2+ years of business process analysis (i.e. documenting
business process, gathering requirements) experience in healthcare
industry or 1+ years of managed care encounters experience.
Advanced knowledge of Microsoft Applications, including Excel and
Access preferred. Knowledge of claims and/or encounter processing
and data analysis experience preferred. Understanding of HIPAA
transactions (i.e. 837, 999, 824, 277) preferred. Knowledge of
managed care information systems and experience in SQL scripting
preferred.
Pay Range: $54,000.00 - $97,100.00 per year Centene offers a
comprehensive benefits package including: competitive pay, health
insurance, 401K and stock purchase plans, tuition reimbursement,
paid time off plus holidays, and a flexible approach to work with
remote, hybrid, field or office work schedules. Actual pay will be
adjusted based on an individual's skills, experience, education,
and other job-related factors permitted by law. Total compensation
may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to
diversity, and values the ways in which we are different. All
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, sexual orientation,
gender identity, national origin, disability, veteran status, or
other characteristic protected by applicable law.
Keywords: Sunshine State Health Plan, Key Biscayne , Business Analyst - Claims, Professions , Hialeah, Florida
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