Business Analyst - ECR
Company: Zelis Healthcare, LLC
Location: Saint Petersburg
Posted on: April 16, 2024
Job Description:
Position OverviewAt Zelis, the Business Analyst - ECR is
ultimately responsible for enabling high quality user stories under
our Expert Claims Review (ECR) product umbrella, which consists of
Itemized Bill Review, Clinical Chart Review, Dialysis Savings
Solution and DRG Validation solutions. User story sourcing and
generation will be expected to be done by being a self-starter and
gathering acceptance criteria from multiple stakeholders in the
business, using a keen analytical ability while also working in an
Agile framework that delivers valued business outcomes and informed
decisions for Zelis' key stakeholders for our solution umbrella.
The Business Analyst works as part of the Product team to
facilitate clear and open communication between Business Owners,
Scrum/Development, Quality Assurance, UAT and Product Owners. This
role provides a major contribution to source technological
improvements, process improvements, enhancements to workflow and
ultimately enhancing Zelis' overall capacity to meet the
information technology needs of an ever-changing payment integrity
market.Key Responsibilities
- Gather requirements/acceptance criteria for Expert Claims
Review initiatives centered around handling of medical pre-payment
and post-payment claims for accurate claim payment review through
our suite of solutions
- Provide documentation for system/process updates and existing
system functionality for reference by operationsand alternate
teams
- Work closely with Product Management, Development, QA and UAT
to ensure requirements are realized properly upon release to
production
- Assist in providing training to operations on newly released
items
- Recommend process, workflow and efficiency improvements while
keeping the team informed on upcoming product development
improvementsand new product solutions being taken to market
- Draft and send release notes and organize user requirements by
scheduling meetings with appropriate stakeholders to track and
manage accordinglyQualifications
- Basic or advanced understanding of payment integrity, claim
processing and/or revenue cycle for healthcare claims
- Understanding of medical coding and medical claims
- Ability to see the big picture and learn new processes,
technologies and envision how they could benefit Zelis
- Ability to partner with one or more Product Owners on key
initiatives and prioritization efforts
- Project Management experience; ability to drive output from
others without direct supervisory responsibility
- Excellent problem solving and analytical skills
- Ability to prioritize and manage multiple concurrent
projects
- Moderate to advanced experience with Microsoft Office Suite,
JIRA + Confluence#LI-RZ1#LI-HybridAs a leading payments company in
healthcare, we guide, price, explain, and pay for care on behalf of
insurers and their members. We're Zelis in our pursuit to align the
interests of payers, providers, and consumers to deliver a better
financial experience and more affordable, transparent care for all.
We partner with more than 700 payers, including the top-5 national
health plans, BCBS insurers, regional health plans, TPAs and
self-insured employers, over 4 million providers, and 100 million
members, enabling the healthcare industry to pay for care, with
care. Zelis brings adaptive technology, a deeply ingrained service
culture, and a comprehensive navigation through adjudication and
payment platform to manage the complete payment process.Commitment
to Diversity, Equity,Inclusion, and BelongingAt Zelis, we champion
diversity, equity, inclusion, and belonging in all aspects of our
operations. We embrace the power of diversity and create an
environment where people can bring their authentic and best selves
to work. We know that a sense of belonging is key not only to your
success at Zelis, but also to your ability to bring your best each
day.Equal Employment Opportunity Zelis is proud to be an equal
opportunity employer. All applicants will receive consideration for
employment without regard to race, color, religion, age, sex,
national origin, disability status, genetics, protected veteran
status, sexual orientation, gender identity or expression, or any
other characteristic protected by federal, state or local laws.We
encourage members of traditionally underrepresented communities to
apply, even if you do not believe you 100% fit the qualifications
of the position, including women, LGBTQIA people, people of color,
and people with disabilities. Accessibility SupportWe are dedicated
to ensuring our application process is accessible to all
candidates. If you are a qualified individual with a disability or
a disabled veteran and require a reasonable accommodation with any
part of the application and/or interview process, please email SCAM
ALERT: There is an active nationwide employment scam which is now
using Zelis to garner personal information or financial scams. This
site is secure, and any applications made here are with our
legitimate partner. If you're contacted by a Zelis Recruiter,
please ensure whomever is contacting you truly represents Zelis
Healthcare. We will never asked for the exchange of any money or
credit card details during the recruitment process. Please be aware
of any suspicious email activity from people who could be
pretending to be recruiters or senior professionals at Zelis.
Keywords: Zelis Healthcare, LLC, Tampa , Business Analyst - ECR, Professions , Saint Petersburg, Florida
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