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Business Analyst III

  • Job Family: Business Support
  • Type: Full time
  • Date Posted:
  • Req #: JR20534

Location:

  • Texas, Texas
  • Iowa, Iowa
  • Indiana, Indiana
  • Arizona, Arizona
  • Virginia, Virginia
  • Minnesota, Minnesota
  • Massachusetts, Massachusetts
  • Tennessee, Tennessee
  • Illinois, Illinois
  • Georgia, Georgia
  • California, California
  • North Carolina, North Carolina
  • Ohio, Ohio
  • Missouri, Missouri
  • Kentucky, Kentucky
  • Arkansas, Arkansas
  • New Jersey, New Jersey
  • Florida, Florida
  • New York, New York
  • Maine, Maine
  • Kansas, Kansas

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Description

Location: Remote 

Responsible for serving as the liaison between the business and IT in translating complex business needs into application software.

How you will make an impact:  

  • Analyzes complex end user needs to determine optimal means of meeting those needs.  

  • Develops project plans and identifies and coordinates resources, involving those outside the unit.  

  • Acts as a resource to users of the software to address questions/issues.  

  • May provide direction and guidance to team members and serves as an expert for the team.  

  • Ability to perform in-depth research and analysis of claims submitted by external vendors and assist with the internalization of recovery opportunities. 

  • Determines specific business requirements to address complex business needs.  

  • Works with Query Developers and Business Consultants to ensure business requirements are incorporated into query design.  

  • Completes and coordinates UAT testing on claims identified as potential overpayments.  

  • Completes all required documentation to support workflows and reporting.  

  • Collaborates with the business partners to approve concepts for recovery.  

  • May provide direction and guidance to team members.  

Minimum Requirements: 

  • Requires a BA/BS and minimum of 5 years business analysis experience; or any combination of education and experience which would provide an equivalent background.  

Preferred Qualifications: 

  • A high level of proficiency in MS Excel is preferred 

  • 3 years preferred In-depth knowledge of WGS Commercial Claims, processing and or adjusting is preferred  

  • 3 years preferred In-depth knowledge if NASCO commercial claims, processing or adjusting is preferred. 

  • In-depth knowledge of pricing arrangements for providers is preferred. 

  • Strong oral, written, interpersonal communication skills and facilitation skills are preferred.  

  • Problem-solving, analytical, and cross team collaboration skills are preferred.  

  • High dollar claims processing is a plus, but not required.  

  • Experience with ClaimsXten (Claims Lab), provider contractual arrangements and pricing agreements, member benefits, UM, authorizations, provider reimbursement policies and pricing methodologies is preferred.  

  • High level of experience with the full suite of Microsoft Office applications (Teams, Share Point, Word, Outlook, OneNote, etc). 

  • Should be both independent and self-motived as well as collaborative to achieve maximum team and department goals.  

  • Needs to be able to work well with others virtually and maintain a high level of efficiency with a key focus on accuracy. 


Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

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.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealthinc.com. 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 ability@icareerhelp.com for assistance.

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