Business Analyst II - Payment Integrity

5 days ago

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Centene Corporation

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Contracting • Network Development • Managed Care

10,000+

Description

• 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

Requirements

• Bachelor’s degree in related field or equivalent experience • 2-4 years of business process or data analysis experience, preferably in healthcare • Advanced knowledge of Microsoft Applications, including Excel and Access preferred • Project management experience preferred • 2+ years of business process analysis, preferably healthcare or claims payment/analysis experience • Advanced knowledge of Microsoft Applications, including Excel preferred • Knowledge of managed care information systems and experience in benefits, pricing, contracting or claims preferred • Knowledge of provider reimbursement methodologies preferred • Previous experience working with claims editing and researching guidelines highly preferred • AAPC or AHIMA Certification preferred • Previous Medical Billing and Coding or Appeals experience preferred

Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules