Healthcare Business Analyst

(none selected) | Fully Remote

Posted: 09/16/2022 Category: Healthcare Job Number: 300184

Job Description

A-Line Staffing is now hiring a Healthcare Business Analyst for a fully remote job opening! The Business Analyst would be working for a Fortune 500 company and has career growth potential. Full time / 40 hours per week.

** Healthcare OR related industry experience REQUIRED **

 

Compensation & Benefits

  • The pay range for this position is $30 - $33 per hour
  • Benefits are available to full-time employees after 90 days of employment and include health, optical, dental, life, and short-term disability insurance
  • A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

Additional highlights

Location: Work from Home / anywhere in the USA

Shift: Monday – Friday, 8:00AM – 5:00PM CST

Note: This position is NOT open to C2C Candidates

 

Responsibilities

  • Maintaining Payment Index (crosswalk application for Contracting, NetOps, and Claims)
    • Payment Index accuracy & quality
    • Pay class configuration accuracy
    • Payment Index and configuration completed prior to contract effective date.
  • Creating & updating pay classes/claims configuration as needed based on new/amended contracts.
  • Performing UAT/configuration testing.
  • Perform audits of provider setup within the provider information system to ensure accurate contract implementation and subsequent claims processing
  • Review and price contract related pends to ensure claims payment accuracy
  • Ensure accurate contract implementation and subsequent claims processing through provider setup, UAT testing, etc. on basic Change Requests (CRs) (i.e.RHCs/FQHCs/fee schedule updates).
  • Troubleshoot and problem solve contract implementation issues related to basic system configuration
  • Review contracts and assign pay classes and applicable provider information based on contract language. If configuration is needed to accommodate a contract, notify the appropriate parties.
  • Assist with the internal communication of all new and revised material contract terms and provisions to all affected departments
  • Review new and current provider contracts and established state guidelines
  • Participate in determining the appropriate configuration of the claims payment process in the appropriate subsystem of the claims payment information system in conjunction with health plan, claims and corporate management and information systems staff

#ALINE3

Job Requirements

Requirements/Experience

  • 1+ years in Provider Contract
  • 2+ years in Health Plan Operations
  • Intermediate level of excel
  • Sql
  • Amisys and/or DST applications (preferred)
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