What are the responsibilities and job description for the Business Analyst (Claims / 837 / Encounters) position at Expert Technology Services?
Job Summary (List Format):
- Lead implementation and optimization of EDI 837 and proprietary healthcare claims files for multiple health plans
- Analyze existing claims data to identify issues and perform root cause analysis to resolve ingestion errors
- Recommend and implement process improvements to ensure accurate claims processing within internal systems
- Develop strong understanding of business rules, core platforms, and applications supporting EDI exchanges
- Design and support end-to-end frameworks for encounter and claims data exchanges
- Facilitate discussions with health plans and internal stakeholders to gather and clarify requirements
- Create and maintain comprehensive documentation, including business requirements, process flows, and technical specifications
- Communicate effectively with both business and technical teams to ensure project alignment and successful delivery
- Work independently in a fast-paced environment, quickly assessing challenges and driving improvements
- Utilize deep expertise in healthcare claims processing and EDI 837 transactions for project success
- Lead implementation and optimization of EDI 837 and proprietary healthcare claims files for multiple health plans
- Analyze existing claims data to identify issues and perform root cause analysis to resolve ingestion errors
- Recommend and implement process improvements to ensure accurate claims processing within internal systems
- Develop strong understanding of business rules, core platforms, and applications supporting EDI exchanges
- Design and support end-to-end frameworks for encounter and claims data exchanges
- Facilitate discussions with health plans and internal stakeholders to gather and clarify requirements
- Create and maintain comprehensive documentation, including business requirements, process flows, and technical specifications
- Communicate effectively with both business and technical teams to ensure project alignment and successful delivery
- Work independently in a fast-paced environment, quickly assessing challenges and driving improvements
- Utilize deep expertise in healthcare claims processing and EDI 837 transactions for project success