Claims Process Improvement Analyst

Independence Blue Cross

Philadelphia (Philadelphia County)

On-site

USD 70,000 - 90,000

Full time

4 hours ago

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Job summary

Independence Blue Cross is seeking a Business Analyst to support BlueCard daily operations and enhance claims processing. You will collaborate with configuration, Account Management, and other teams to resolve discrepancies, perform root cause analysis, and drive process improvements using data and automation tools.

Required are strong Excel/Office skills, familiarity with SQL and data pivoting, and a focus on accurate, timely resolutions.

Qualifications

3+ years of experience in medical claims processing or healthcare administration.
Strong knowledge of medical billing codes (ICD-10, CPT, HCPCS).
Ability to summarize large datasets and pivot data multiple ways.
Experience with claim processing software and data analysis.
Proficient in Microsoft Excel and data tools; building process improvements.

Responsibilities

Analyze claim issues and perform root cause analysis to drive full resolution.
Collaborate with cross-functional teams to resolve member discrepancies and improve processing experience.
Research root causes of incorrectly processed claims and coordinate repairs and training.
Apply data-driven approaches and tools to enhance claims processes and automation.
Document processes and assist with data extraction for reporting.