Senior Business Operations Analyst - Claims (EDI)

Collective Health•Plano, TX

1d•Hybrid

About The Position

At Collective Health, we’re transforming how employers and their people engage with their health benefits by seamlessly integrating cutting-edge technology, compassionate service, and world-class user experience design. At Collective Health, we care about creating a culture of diversity, openness, and transparency, while engaging our curiosity. You will be part of a team rebuilding our member claims integration platform, working on the latest technologies to support the important processes for streamlined and smooth business operations. What you'll do: Implement E2E process for partner integrations including, but not limited to, understanding technical specification documents, translating those into requirements, synthesizing additional internal requirements, implementing those specifications, testing end-to-end process, and handling production readiness/go-live activities. Have the operational oversight, as it pertains to receipt, tracking, importing/exporting, and balancing of Electronic Data Interchange (EDI) files sent to and received from partners Report to the Engineering/Operations Manager and require minimal degree of management to ensure tasks are prioritized Occasionally provide direction and guidance to team members and serves as/develop into an Operations SME for the team Lead meetings to review issues and/or recommendations for improvement Use process improvement methodologies/techniques to eliminate waste, duplication and improve processes Coordinate the uploading/balancing/inventory/verification of electronic files with claims with the appropriate platform (Production Engine etc), and tracks/reports all discrepancies promptly Apply knowledge of the business environment to help support implementation and maintenance of software products used by our company Troubleshoot designated software and application-based issues, review log files, report issues, and work collaboratively with the integration engineering and operations teams to address those issues Ensure integrity of the validation process on all data intake processes Support ad-hoc reporting to support projects Support interfaces to/from application environments

Requirements

BA/BS degree, 2 or more years business analysis experience
Understanding of claims department operational responsibilities and overall workflow
Analysis techniques, work as part of the Agile Business process team
Excellence in written documentation including requirements, process flow maps, and use cases
Deep familiarity with X12 5010 standards & knowledge of End-to-End Claims Lifecycle Management.
Experience with Healthcare EDI file formats such as 837 (institutional and professional), 835, Fund Report, etc.
Experience in Atlassian products such as JIRA and Confluence - including extensions.
Experience with source code management and API tools such as Git and Postman.
Written and oral communication skills and ability to multi-task in a fast-paced environment
Experience with data analysis and the ability to report writing in specific reporting applications
Ability to engage diplomatically with partners and communicate changes that may not be aligned with the original expectations

Responsibilities

Implement E2E process for partner integrations including, but not limited to, understanding technical specification documents, translating those into requirements, synthesizing additional internal requirements, implementing those specifications, testing end-to-end process, and handling production readiness/go-live activities.
Have the operational oversight, as it pertains to receipt, tracking, importing/exporting, and balancing of Electronic Data Interchange (EDI) files sent to and received from partners
Report to the Engineering/Operations Manager and require minimal degree of management to ensure tasks are prioritized
Occasionally provide direction and guidance to team members and serves as/develop into an Operations SME for the team
Lead meetings to review issues and/or recommendations for improvement
Use process improvement methodologies/techniques to eliminate waste, duplication and improve processes
Coordinate the uploading/balancing/inventory/verification of electronic files with claims with the appropriate platform (Production Engine etc), and tracks/reports all discrepancies promptly
Apply knowledge of the business environment to help support implementation and maintenance of software products used by our company
Troubleshoot designated software and application-based issues, review log files, report issues, and work collaboratively with the integration engineering and operations teams to address those issues
Ensure integrity of the validation process on all data intake processes
Support ad-hoc reporting to support projects
Support interfaces to/from application environments