Analyst, ROC Product

PDS Health•Irving, TX

1d•$59,000 - $75,000

About The Position

The Analyst, ROC Product supports the ROC team by obtaining, analyzing, and communicating information that informs the development of new products. The role contributes to product strategy with a data-driven, customer-oriented focus and engages internal and external clients to gather validation and input on development initiatives. The analyst develops insights that help guide company direction. The position also supports billing operations by auditing patient claims, checking their consistency and quality, analyzing Explanation of Benefits (EOB) statements, and adjusting accounts according to PDS claims processing criteria. The analyst monitors performance metrics, investigates changes, communicates insights on projects, and reports regularly on accomplishments, improvement areas, goals, and process effectiveness.

Requirements

Bachelor's degree in Business Management or a related field; alternatively, four or more years of experience or an equivalent combination of education and experience.
4–6 years of related experience in product analysis or dental or medical billing operations.
Knowledge of QSI software applications.

Nice To Haves

Experience in a multi-regional healthcare, retail, or dental company.
Ability to read and interpret Explanation of Benefits (EOBs).
Prior customer service experience.

Responsibilities

Identify product opportunities, assess experiment performance, and define business metrics.
Collaborate with internal and external stakeholders to gather requirements and map, structure, document, and validate technical requirements for new or enhanced ROC products.
Research, document, and share information about product industry and competitor trends, features, and news.
Create process diagrams, use cases, and business, functional, and non-functional requirements; develop use cases and functional requirements for feature development.
Analyze and audit claims submitted by billers to identify inconsistencies.
Ensure submitted claims meet company consistency and quality standards.
Analyze EOB statements and adjust accounts according to PDS claims processing criteria.
Audit patient claims daily to support accurate and maximum reimbursement for treatment from insurance carriers.
Analyze and communicate key insights for existing projects and serve as a thought leader and subject matter expert for specific business problems.
Monitor key performance metrics and identify root causes of changes.
Report weekly to the Sr. Manager of Billing Operations on accomplishments, areas for improvement, performance goals, and the effectiveness of existing processes and systems.
Perform other duties as assigned by management.