Location: Indianapolis IN, Atlanta GA, Norfolk VA, Tampa FL, Louisville KY, Nashville TN, Grand Prairie TX

Hours: Standard Working hours

Travel: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Position Overview:

This role is crucial in recovery operations, where the BA II engages with various stakeholders to gather essential data to understand billing and payment requirements, and pinpoint sources of overpayments. While collaborating with the query team, the BA II helps establish necessary business requirements for overpayment concepts used to identify related claims.

How You Will Make an Impact:

• Serving as a liaison, the BA II works closely with Health Plans and their staff to address workflow inquiries, adapt to evolving concepts/tasks, and ensure that financial targets are consistently met

• Responsible for researching and maintaining comprehensive documentation, such as policies, manuals, and contracts, which support operational transparency

• Crafts validation instructions to guide downstream departments in accurately reviewing claims related to overpayment scenarios

• Strong writing skills are essential for drafting clear, precise communication for provider letters that explain overpayment reasons

• Manage Ad Hoc recovery initiatives and handle monthly low-complexity recurring leads, while analyzing recovery reports to enhance claim validation accuracy and identify areas for process improvement

• This position offers an opportunity for foundational growth and development within the Payment Integrity sector

Required Qualifications:

• Requires a BA/BS and minimum of 3 years related business analysis experience, or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications:

• Experience with Medicaid, Medicare, Commercial lines of business preferred

• Claims Processing Experience is a must

• COB experience strongly preferred

• Data analysis experience preferred

• GBD FACETS experience Preferred

• WGS experience Nice to have

• Attention to detail strongly preferred

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.