Technical Business Analyst - Healthcare Billing

Quadax, Inc.Middleburg Heights, OH
Hybrid

About The Position

We are seeking a detail-oriented and technically proficient Technical Business Analyst with expertise in healthcare billing systems to join our team. This role will serve as a critical link between business stakeholders and IT, ensuring that billing processes are optimized, compliant, and aligned with organizational goals.

Requirements

  • Bachelor’s degree in Business, Information Systems, Healthcare Administration, or related field.
  • 3+ years of experience as a Business Analyst, preferably in healthcare or billing systems.
  • Strong understanding of healthcare billing processes, coding standards (ICD-10, CPT, HCPCS), and payer requirements.
  • Proficiency in SQL and data visualization/reporting tools.
  • Excellent communication, analytical, and problem-solving skills.

Nice To Haves

  • Familiarity with HL7 and JSON data structures.
  • Familiarity with HIPAA and CMS compliance standards.
  • Agile/Scrum experience.

Responsibilities

  • Gather, analyze, and document business and technical requirements.
  • Translate business needs into functional specifications and user stories.
  • Conduct gap analyses and recommend process improvements.
  • Facilitate stakeholder meetings to define project scope and objectives.
  • Support QA and UAT efforts by validating test cases and outcomes.
  • Analyze system capabilities and recommend enhancements.
  • Create and maintain documentation including process flows, data models, and integration maps.
  • Troubleshoot and resolve system issues related to billing workflows.
  • Analyze and optimize workflows related to medical billing and client specific Use Cases.
  • Knowledge regarding compliance with HIPAA, CMS guidelines, and payer-specific billing requirements.
  • Monitor and analyze order and claim data received from our client.
  • Support integration of billing systems.
  • Assist in audit and reconciliation processes by providing system data and documentation.
  • Develop and maintain dashboards and reports using tools like SQL or Power BI.
  • Perform data analysis to support decision-making and identify trends in billing performance.
  • Ensure data integrity and consistency across systems.
  • Contribute to project planning, timelines, and resource allocation.
  • Support change management initiatives including training and documentation.
  • Track and report on project progress, risks, and issues.
  • ServiceNow event logging and verification of change control compliance
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