Expert Claims Review Business Analyst

Zelis • St. Louis, MO

2d • $71,000 - $90,250 • Hybrid

About The Position

The Business Analyst is responsible for enabling high quality business analytics solutions in an Agile or Kanban context that deliver valued business outcomes and informed decisions for Zelis’ key stakeholders. The Business Analyst works as part of the Scrum team to facilitate clear and open communication between Business Owners, Development, Quality Assurance, and the Product Owner. This role provides a major contribution to enhancing Zelis’ overall capacity to meet the information technology needs of an ever-changing healthcare market. One of the core skills of a Business Analyst is requirements management (i.e., user and enabler stories). Developing stories and accurately defining the business solution begins with eliciting, understanding, and analyzing and the needs of the business. A core competency of this role is critical thinking, disciplined thinking that is clear, rational, open-minded, and informed by evidence. This person will act as liaison among Business Owners and/or Solutions Owners (i.e., Product Owner) to gather, analyze, document, communicate and validate business and system requirements and business methodologies. They will create and maintain Kanban or Agile artifacts which could include but are not limited to Workflows/diagrams, User Stories, Enabler Stories, Release Notes, User Guides. Business Analysts will always look for ways to improve the current state (“AS-IS”) by recommending a more efficient future state (“TO-BE”).

Requirements

• Bachelor’s Degree
• 4+ years of experience with Business Analysis and/or Business Process Engineering
• Disciplined, structured and logical approach to problem solving
• SQL experience preferred
• Ability to learn a new business and translate these needs into new products, and perform high-level troubleshooting functionality
• Solid troubleshooting, analytical, and business process development skills
• Clear and concise communication both verbally and in writing.

Nice To Haves

• Experience in Healthcare industry preferred
• Knowledge of Payment Integrity solutions (hospital billing, claims editing, reimbursement methodologies and acceptable billing practices) preferred
• Knowledge of payer reimbursement policies, state and federal regulations and applicable industry standards preferred
• Preferred - SAFe POPM, Agilist, Teams, or Leading Safe certification

Responsibilities

• Participate in relevant ceremonies: Daily Stand-Ups, Backlog Grooming, Sprint Planning, Sprint Review, Sprint Retrospective.
• Leverage AI through all aspects of the role to facilitate user stories and requirements, acceptance criteria or any other aspect of their role
• Assist with the elaboration of the user stories and requirements, supporting team members with their work where required
• Be responsible for providing multi-disciplinary teams with user stories and coaching to define the business-driven acceptance criteria and test cases.
• Proactively support the uplift of Agile or Kanban practices and foster a culture of continual service improvement
• Consult with the business and product owners to prioritize and shape the product backlog, using Agile or Kanban practices for prioritization around business value
• Define, implement, and maintain business processes and procedures to meet business objectives.
• Analyze and identify opportunities for business process improvements.
• Collaborate with Solution Owners and/or Product Managers when defining product release content and timeline, applying product development principles, innovative thinking and a focus around the customer or user experience
• Critically evaluate information gathered from multiple sources, reconcile conflicts, and decompose high-level information into details.
• Create and maintain workflows, approval processes, and validation rules based on internal stakeholder requirements.
• Create training materials and documentation for internal and/or external applications.
• Perform a thorough gap analysis of existing to potential functionality for internal and/or external applications.
• Create Release Notes as determined by Product Owner.
• Perform analysis and identify gaps in functionality for system integrations.
• Collaborate with the Scrum team to establish the technical vision and analyze tradeoffs between usability and performance needs.
• Improves systems by studying current practices, designing modifications.
• Assist in Quality Assurance (QA) and/or User Acceptance Testing (UAT) of new software or enhancements to existing software as needed.
• The ability to multi-task and work on multiple assignments will be required.

Benefits

• 401k plan with employer match
• flexible paid time off
• holidays
• parental leaves
• life and disability insurance
• health benefits including medical, dental, vision, and prescription drug coverage

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level