Analyst, ROC Product

PDS Health; Irving (TX); On-site; USD 59,000 - 75,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Paid time off

Tuition Reimbursement

401K

Paid time to volunteer in your local社区

Job summary

PDS Health in Irving, TX is seeking an Analyst, ROC Product to support the ROC team by obtaining, analyzing and communicating information that informs the development of new products and strategy. You will collaborate with internal and external stakeholders to gather requirements and map technical needs for ROC features.

The role involves researching industry trends, documenting use cases and requirements, auditing claims and EOBs, and delivering insights to drive business decisions.

Qualifications

• Bachelor's degree or 4+ years of related experience in product analysis or billing operations.
• Experience with QSI software applications.
• Strong analytical and communication skills for cross-functional teams.

Responsibilities

• Identify product opportunities, define metrics and analyze experiment performance.
• Collaborate with stakeholders to gather requirements and validate technical needs.
• Research industry trends and document use cases and functional requirements.
• Audit claims to ensure consistency and maximize reimbursement.
• Analyze EOB statements and adjust accounts per processing criteria.
• Provide insights to inform existing projects and drive business decisions.
• Report weekly on accomplishments and improvement opportunities.

Skills

Data analysis

Communication

Stakeholder collaboration

Education

Bachelor's Degree in Business Management or related field

Tools

QSI software

Job description

Now is the time to join PDS Health. You will have opportunities to learn new skills from our team of experienced professionals. If you're ready to take your career to the next level and gain valuable experience.

The Analyst, ROC Product is responsible for supporting the ROC team through obtaining, analyzing and communicating information that provides insight in the development of new products. The incumbent will be instrumental in the execution of product strategy with data driven and customer oriented focus. The incumbent will have internal and external client interactions to obtain validation and input into current development initiatives. The incumbent will create insights that drive the direction of the company.

Responsibilities

• Identifying product opportunities, understanding experiment performance, and defining metrics for the business.
• 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 disseminate information of product industry and competitor trends, features, and news.
• Create documentation including process diagrams, use cases, business, functional, and non-functional requirements; developing use cases and functional requirements for features development.
• Analyze and audit claims submitted by the billers to identify inconsistencies.
• Ensure all claims submitted meet the consistency and quality standards of the company.
• Analyze Explanation of Benefits (EOB) statements and adjust accounts according to PDS claims processing criteria.
• Perform daily activities of auditing patient claims billed to ensure accurate and maximum reimbursement for patient treatment from insurance carriers.
• Analyze and communicate key insights for existing projects and act as a thought leader and subject matter expert for specific business problems.
• Monitor key performance metrics and understand root causes of change.
• Report weekly to Sr. Manager of Billing Operations detailing accomplishments, areas for improvement, clear performance goals, and effectiveness of existing processes and systems.
• Other duties as assigned by management.

Required

• Bachelor's Degree in Business Management or a related field. In lieu of degree, +4 years of experience is required or the equivalent combination of education and experience.
• 4-6 years of related experience in product analysis, dental or medical billing operations.
• Knowledge of QSI software applications.

Preferred

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

Benefits

• Medical, dental, and vision insurance
• Paid time off
• Tuition Reimbursement
• 401K
• Paid time to volunteer in your local community

Compensation Information

$59,000.00-$75,000.00 / Annually

PDS Health is an Equal Opportunity Employer. We celebrate diversity and are united in our mission to create healthier and happier team members.