Senior Quality Business Analyst

Blue Cross and Blue Shield Association

Philadelphia, PA

JOB DETAILS
SKILLS
Analysis Skills, Auditing, Budget Management, Business Analysis, Business Support, Claims Processing, Communication Skills, Documentation, Identify Issues, Knowledge Transfer, Operational Support, Policy Development, Presentation/Verbal Skills, Procedure Development, Process Development, Process Flow, Process Improvement, Regulations, Test Case, Test Design, Test Requirements, Testing, Time Management, Trend Analysis, User Documentation, Writing Skills
LOCATION
Philadelphia, PA
POSTED
30+ days ago

The FEP Sr. Quality Business Analyst supports FEP Claims Operations with ensuring the quality of the transaction work performed by FEP Claims Operations and the processing vendor. The FEP Sr. Quality Business Analyst also participates in the various FEP Claims Operations transaction workstreams.

  • 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

  • Familiarity with FEP process flows, regulatory impacts and timelines to ensure requirements, testing and implementation are in compliance across operational disciplines.

  • Proven experience to assess 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

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

About the Company

B

Blue Cross and Blue Shield Association

At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry. We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.
COMPANY SIZE
2,000 to 2,499 employees
INDUSTRY
Insurance
WEBSITE
https://www.bcbs.com/about-us/careers