Healthcare Claims & Process Improvement Analyst

Independence Blue Cross, LLC; Philadelphia (Philadelphia County); Presencial; USD 70.000 - 100.000; Jornada completa

Descripción de la vacante

Independence Blue Cross, LLC, a leading US health plan, seeks a Business Analyst to support claim operations, benefits, provider data, and services through process improvements and system enhancements. From discovery to validation, the role improves processing accuracy, efficiency, and member/provider experience.

The analyst will gather requirements, analyze workflows and data, collaborate with operations, technology, and vendors, and ensure traceability through tests and deployments, driving

Formación

• Bachelor's degree in business administration, healthcare administration, or related field.
• 2+ years of business analysis experience in a health plan or payer environment.
• Experience with health plan workflows such as claims processing and benefit administration.
• Strong analytical and problem-solving skills with data interpretation abilities.
• Proficiency with Excel, Word, PowerPoint, SQL and Tableau; familiarity with process mapping.

Responsabilidades

• Gather, analyze, validate, and document business requirements for claims, benefits, provider data, and member and provider inquiry processes.
• Evaluate workflows, investigate processing errors and service issues, and recommend improvements based on root-cause analysis.
• Analyze data to identify trends, reconcile discrepancies, and report on performance metrics.
• Partner with operations, technology, provider network teams, and vendors to clarify requirements and coordinate system changes.
• Maintain traceability among business needs, approved requirements, and test results, including provider contracts and compliance guidance.
• Support implementation through procedure updates and post-implementation validation.
• Track deliverables, communicate progress, and elevate risks and dependencies promptly.

Descripción del empleo

Independence Blue Cross, LLC, a leading US health plan, seeks a Business Analyst to support claim operations, benefits, provider data, and services through process improvements and system enhancements. From discovery to validation, the role improves processing accuracy, efficiency, and member/provider experience.

The analyst will gather requirements, analyze workflows and data, collaborate with operations, technology, and vendors, and ensure traceability through tests and deployments, driving