Hybrid Payment Integrity Datamining Analyst II

Elevance Health; Mason (OH); Hybrid; USD 65,000 - 97,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Job summary

Elevance Health is seeking a Business Analyst II for Payment Integrity Datamining in Maryland. The role combines in-office collaboration 1-2 days per week with flexible, hybrid work, translating business needs into software requirements.

You will analyze claims data to identify overpayments, work with development teams, and liaise with users to ensure accurate recovery and policy documentation.

Qualifications

• BA/BS and minimum 3 years of business analysis experience.
• Experience with healthcare payer systems and claims data.
• Familiarity with ICD, CPT, HCPCS is a plus.
• Translate business needs into software requirements.
• Strong written communication and policy documentation.

Responsibilities

• Analyzes business needs to determine optimal means of meeting those needs.
• Determines specific software requirements to address business needs.
• Collaborates with programming staff to ensure requirements are incorporated into design and testing.
• Acts as liaison with users of the software to address questions/issues.

Skills

Healthcare payer systems

Claims data analysis

Data extraction/insights

Policy documentation

Stakeholder communication

Process improvement

Education

BA/BS degree

Job description

Elevance Health is seeking a Business Analyst II for Payment Integrity Datamining in Maryland. The role combines in-office collaboration 1-2 days per week with flexible, hybrid work, translating business needs into software requirements.

You will analyze claims data to identify overpayments, work with development teams, and liaise with users to ensure accurate recovery and policy documentation.