Healthcare Business Analyst
- Job Title
- Healthcare Business Analyst
- Job ID
- Doral, FL 33166
- Other Location
From our start in 2009, Conexess has established itself in 3 markets, employing nearly 200+ individuals nation-wide. Operating in over 15 states, our client base ranges from Fortune 500/1000 companies, to mid-small range companies. For the majority of the mid-small range companies, we are exclusively used due to our outstanding staffing track record
Who We Are:
Conexess is a full-service staffing firm offering contract, contract-to hire, and direct placements. We have a wide range of recruiting capabilities extending from help desk technicians to CIOs. We are also capable of offering project based work.
***Unable to work C2C****
Conexess Group is aiding a local client in their search for a Healthcare Business Analyst. In this role you will create and maintain Facets benefit components for new and renewing for Medical group as well as updating and maintaining all documentation related to changes.
- Participates in meetings representing Benefit Configuration Administration to fully understand plan benefits and validate Facets capabilities.
- Ensures benefit configuration turnaround times are met for all request.
- Lead on inquiries from Claims, Professional Relations and Business Units regarding contract and product set-up issues on all products.
- Performs testing on claims to validate benefit configuration will meet the needs of the Claims department.
- Assists with department projects and reports at the direction of department management
- Interprets benefit information from the group application and or contract language in order to create a product within corporate turnaround time standards.
- Documents departmental policies and business processes as assigned by department management.
- Lead contact for configuration in any of the following areas: claims, subscriber family, clinical editing, and utilization management Performs other duties as assigned
- Must have ability to exercise independent judgment in planning, organizing, and performing systems analyst tasks.
- Knowledge with TriZetto Facets.
- Knowledge with Optum products; CES, PPS, and Optum pricing systems.
- EDI X12 Background a plus.