Business Analyst

Innova Solutions Inc.; Philadelphia, Northern (Philadelphia County, KY); Hybrid; USD 62,000 - 66,000; Full time

Benefits offered by this job

Referral bonus

Job summary

Innova Solutions is actively hiring a Business Analyst to support BlueCard daily operations and drive improvements in claims processing. You will analyze claim data, identify root causes, and coordinate with configuration and Account Management teams to resolve discrepancies and enhance member experience.

The role requires 3+ years in medical claims processing or healthcare administration, with strong knowledge of ICD-10, CPT, HCPCS codes and BlueSquared.

Qualifications

• 3+ years in medical claims processing or healthcare administration.
• Expertise in the Blue Squared application.
• Knowledge of ICD-10, CPT, HCPCS codes and claims processing software.
• Ability to summarize large data sets and pivot data in multiple ways.
• Ability to assess claim data in detail and identify errors or inefficiencies.
• Strong written and verbal communication for stakeholders and issue resolution.
• High level of accuracy and thoroughness in reviewing claims.

Responsibilities

• Support BlueCard daily operations and resolve operational challenges.
• Assist with analyzing claim issues and inquiries for the processing team.
• Perform root cause analysis and implement corrective actions.
• Collaborate with cross-functional teams to resolve member claim issues.
• Research causes of incorrectly processed claims and coordinate enhancements.
• Apply data-driven methods and tools to improve claims processing efficiency.

Skills

Medical claims processing

Blue Squared

Medical billing codes

Data summarization

Data pivoting

Communication skills

Tools

Blue Squared

Job description

A client of Innova Solutions is immediately hiring for a Business Analyst

Position type: Full time – Contract to hire

Duration: 4-month contract

Location: Philadelphia, PA 19103 (Onsite)

Bloomington, MN
Tampa, FL
Salt Lake City, UT
Houston, TX
Columbus, OH

As a Business Analyst, you will:

• Seeking strong Business Analyst to support BlueCard daily operations.
• This support will assist to move forward resolution of operational challenges, improve current processes and support project management initiatives. You will work closely with other team members and cross functional teams such as configuration and Account Management to resolve discrepancies and improve claims processing experience for BlueCard members
• Support the processing team with analysis of claim issues and inquiries.
• Perform root cause analysis and course correct identified issues for full resolution.
• Work with other plans to resolve issues for members
• Research root cause of incorrectly processed claims, failed DF and RFs.
• Provide solutions and coordinate with appropriate team members to repair the claim and provide re-education to the processor or submit ticket for system enhancement.
• Focus on applying technologies to continuously increase claims process improvements with the use of data, Bots and applications/tools.
• Share this knowledge and skill with other team members to instill across the team the opportunities that they can elevate to process improve. Schedule reoccurring meetings to keep momentum.
• Responsible for evaluating current business processes and developing, implementing, testing and maintaining Technology for more cost effective or quality improvement processing.
• Assist with pulling the data needed and assist with the documentation of processes and work procedures.
• Represent Department as SME in meetings, projects and company initiatives

The ideal candidate will have:

• 3 years or more of experience in medical claims processing and adjusting or healthcare administration.
• Expertise in the Blue Squared application
• Knowledge of medical billing codes (ICD-10, CPT, HCPCS), claims processing software, and a strong understanding of the BlueCard product.
• Ability to summarize large amounts of data and pivot data in multiple ways
• Ability to assess claim data in detail and identify errors or inefficiencies.
• Possess excellent mathematical skills and have the ability to work independently and within tight timeframes.
• Strong written and verbal communication skills for interacting with various stakeholders and resolving issues quickly.
• High level of accuracy and thoroughness in reviewing claims for clients

PAY RANGE AND BENEFITS:

Pay Range*: $45 - $48 per hour

*Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc.

Benefits: Innova Solutions offers benefits( based on eligibility) that include the following: Medical & pharmacy coverage, Dental/vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP).

ABOUT INNOVA SOLUTIONS:

Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields.

Named One of America’s Best Employers for New Grads by Forbes (2024)

Named One of the Best Companies to Work for by U.S. News & World Report (Private Companies List, 2024-2025)

One of the Largest IT Staffing Firms in the US – Ranked #3 by Staffing Industry Analysts (SIA, 2024)

One of the Largest Staffing Firms in the US – Ranked #13 by Staffing Industry Analysts (SIA, 2024; includes Innova Solutions, Volt, & HireGenics)

Named One of the Top Ten Private Companies in Atlanta by the Atlanta Business Chronicle (2023)

One of the Largest Certified Minority Business Enterprises (MBEs) in the United States (NMSDC, 2024)

AWS Advanced Tier Services Partner with 100+ certifications

Website:

https://www.innovasolutions.com/

Innova Solutions

Innova Solutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment, please contact us at [e-mail] or [phone]. Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities. Innova Solutions (HireGenics/Volt) does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. § 1324b.

The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.

Referral Program:

This position qualifies for a Referral Bonus amount of $250-$1000 dollars.

Referral Program. Please email your referral details along with their resume to [e-mail].

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