Healthcare Business Analyst - Expert Claims Review
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About The Position
At Zelis, the Business Analyst - Expert Claims Review (ECR) plays a crucial role in ensuring the delivery of high-quality user stories under the ECR product umbrella. This encompasses various solutions including Itemized Bill Review, Clinical Chart Review, Dialysis Savings Solution, and DRG Validation solutions. The individual in this position will collaborate closely with the Product team to foster clear and open communication among Business Owners, Scrum/Development teams, Quality Assurance, User Acceptance Testing (UAT), and Product Owners. This role is pivotal in identifying technological improvements, enhancing processes, and optimizing workflows, which ultimately boosts Zelis' capacity to address the evolving information technology needs within the payment integrity market. The Business Analyst will be responsible for gathering requirements and acceptance criteria for Expert Claims Review initiatives, focusing on the management of medical pre-payment and post-payment claims to ensure accurate claim payment reviews through our suite of solutions. This includes providing comprehensive documentation for system and process updates, as well as existing system functionalities for reference by operations and other teams. Additionally, the role involves supporting training initiatives for operations on newly released items and recommending improvements in processes, workflows, and efficiencies. The Business Analyst will also communicate product development enhancements and new product solutions being introduced to the market, draft and distribute release notes, and manage user requirements effectively. In this dynamic role, the Business Analyst will contribute significantly to the overall success of Zelis by ensuring that the products and solutions meet the high standards expected in the healthcare payment processing industry. The position requires a blend of analytical skills, project management experience, and a solid understanding of payment integrity and claim processing, making it essential for the candidate to be proactive and detail-oriented.
