Quality Business Analyst

Alpha Business Solutions

Philadelphia, PA

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JOB DETAILS

SALARY

$35–$38 Per Hour

SKILLS

Analysis Skills, Auditing, Budget Management, Business Analysis, Claims Processing, Communication Skills, Dental Insurance, Documentation, Insurance Claims, Knowledge Transfer, Policy Development, Presentation/Verbal Skills, Procedure Development, Process Development, Process Flow, Process Improvement, Quality Assurance, Regulations, Systems Maintenance, Test Case, Test Design, Test Requirements, Testing, Time Management, Trend Analysis, User Documentation, Vision Plan, Writing Skills

LOCATION

Philadelphia, PA

POSTED

23 days ago

Position: Sr. Quality Business Analyst
Location: Local to the office for hybrid is highly preferred, but would consider a remote candidates in Columbus, OH, Salt Lake, UT, Houston, TX and Bloomington, MN. *Must be in tristate (PA, NJ, DE) or within an hour of Columbus, OH, Salt Lake, UT, Houston, TX and Bloomington, MN to be eligible to convert.
Duration: 6+ Months

Candidates must have FEP Claims experience professional or facility and experience with claims quality assurance and auditing

Description
Review FEP transactions to ensure accuracy of transaction and
system processing. Provide timely documented feedback on
issues identified at the processor and/or system level and
execute escalation procedures if applicable
Maintain flexibility in a team environment and identify process improvement opportunities and define system impacts that may result.
Ability/willingness to participate in departmental knowledge transfer activities to facilitate cross-training efforts.
Actively represents the FEP Claims Team on various projects and possesses proven ability to identify required action items and impacts.
Represent FEP Claims Team on assigned projects, providing feedback and assessing impacts accordingly
Identify FEP process improvements and develop workflow and/or system recommendations
Support lead analyst or supervisor in all project related activities (analysis, tracking, etc.)
Develop and maintain FEP user documentation ensuring the most current information is available to the production areas.
Communicate effectively in writing and verbally with in work groups and internal and external customers
Attend internal and external education training to achieve and maintain proficiency on all systems
Support assigned projects, maintain appropriate documentation at a task level, monitor deadlines and budget allocations and service as a technical liaison when appropriate
Assist with designing test plans and evaluate/ test new or modified processes and procedures to verify that the new programs or program changes are functioning as intended and conform to established policies. Maintain detailed testing notes, cases and outcomes to support all findings

External Qualifications
Familiarity with FEP process flows, regulatory impacts and timelines to ensure requirements, testing and implementation are in compliance across operational disciplines.
Proven experience assessing FEP regulations and required controls and incorporating what is required into the specifications and/or documentation
Proven ability to compile FEP detailed system requirements, reporting and data mining to support business needs that meet the need.
Proficient in FEP trend analysis and communicating as the liaison with business partners on findings and recommendations focused on minimizing impacts to other areas and the customer.
Superior written and verbal communication skills are required to provide business units with FEP information and tools to support system modifications and/or new installations.

Required:
FEP Facility Claims Processing and adjustment experience
FEP Facility Claims Quality and Audit experience
Minimum of 5 to 8 years work related experience
BS/BA Undergraduate degree or equivalent related experience

Benefits:
We offer a competitive compensation package that includes:
· Pay Rate: $35 - $38 per/hour W2
o Note: Pay rate will be commensurate with experience.
· Medical for full time employees
· Dental, and Vision Insurance
· Life Insurance, Short-Term Disability, Long-Term Disability, etc.

Quality Business Analyst

Alpha Business Solutions

Philadelphia, PA

About the Company

Alpha Business Solutions

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