Business Analyst - Claims

TechDigital Group; Charlotte (NC); On-site; USD 95,000 - 145,000; Full time

Job summary

An established industry player is seeking a seasoned Business Analyst with extensive experience in Workers' Compensation claims. This role demands a deep understanding of statutory and compliance reporting, alongside a proven track record in integrating multiple vendors for effective claims handling. The ideal candidate will thrive in an agile environment, showcasing their ability to create clear deliverables that align business needs with software functionality. Join a dynamic team where your expertise in business analysis will drive significant improvements and automation in business processes.

Qualifications

• 10+ years of experience in business analysis, particularly in Workers Comp Claims.
• Strong understanding of statutory and compliance reporting for multi-jurisdictional claims.
• Experience integrating multiple vendors for Workers' Compensation claim handling.
• Strong experience with claims management and medical bill review solutions.
• Experience with iterative and agile methodologies, with working knowledge of SDLC & PMLC.

Responsibilities

• Integrate multiple vendors for Workers' Compensation claim handling.
• Create business process diagrams and functional requirements for IT solutions.

Skills

Business Analysis

Workers Compensation Claims

Statutory and Compliance Reporting

Claims Management

Medical Bill Review

Agile Methodologies

SDLC

PMLC

Business Process Diagrams

Functional Requirements

Job description

Mandatory required skills: Worker Compensation – Claims process

1. 10+ years of business analysis experience, with 3+ years within the space of Workers Comp Claims.
2. Must have a clear understanding and experience with the statutory and compliance reporting requirements and best practices for multi-jurisdictional Workers' Compensation claims.
3. Extensive experience with integrating multiple vendors needed for Workers' Compensation claim handling.
4. Strong experience with claims management and medical bill review solutions.
5. Experience with iterative and agile methodologies, with working knowledge of both SDLC & PMLC processes.
6. Proven hands-on experience with creation of business process diagrams, data rules, business requirements, and functional requirements / user stories.
7. Possess knowledge and experience when reviewing, re-engineering, or developing IT solutions for business process / improvements automation.
8. Candidate has experience operating and interfacing with business management during walkthrough, interview, presentation, and negotiation processes.
9. Proven track record for creating clear, concise deliverables which reflect a deep understanding of business needs and software functionality.