Senior Business Systems Analyst - Claims and Revenue Cycle

ALEXIAN VILLAGE OF MILWAUKEE; United States; Remote; USD 55,000 - 90,000; Full time

Job summary

An established industry player is seeking a dedicated Data Analyst to support their Population Health and Insurance initiatives. In this role, you will collaborate with stakeholders to identify and document data needs, while ensuring high-quality data mapping and analysis. You'll leverage your expertise in relational databases and SQL to drive improvements in healthcare data processes. Join a team committed to compassionate care, where your contributions will enhance community health outcomes and support innovative healthcare solutions. This is an exciting opportunity to grow your career in a dynamic and supportive environment.

Benefits

Paid Time Off (PTO)

Health Insurance Options

Retirement Benefits

Tuition Reimbursement

Employee Assistance Programs

Parental Leave

Community Service Opportunities

Qualifications

• Experience in healthcare data analysis and claims processing.
• Strong SQL skills and understanding of relational databases.

Responsibilities

• Collaborate with stakeholders to identify data needs and gaps.
• Perform mapping of claims and clinical data into normalized models.
• Act as a subject matter expert for Population Health and Insurance data.

Skills

Data Analysis

SQL

Population Health Knowledge

Claims Processing

Critical Thinking

Education

High School Diploma or Equivalent

Associate's Degree

Bachelor's Degree in Health or Finance

Tools

Relational Databases

Healthcare Information Systems

Job description

Details

• Department: Data Delivery Governance
• Schedule: Full time
• Location: Remote

Benefits

Paid time off (PTO)
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your community

Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance and salary range at the time of the offer.

Responsibilities

• Works with stakeholders to discover, clarify, and document current andfuture data needs.
• Performs mapping of claims, insurance, revenue and supplemental clinical datainto a normalized data model.
• Serves as a subject matter expert on the Population Health and Insurance data domains such as Medical Claims, Pharmacy Claims, Dental Claims, Eligibility, Member PCP, Provider, Revenue.
• Builds data concepts to support Population Health, Insurance and Revenue Cycle use cases.
• Serves as a key resource for an assigned customer area to understand and explain business and technical issues and to provide viable technology solutions.
• Supports: clinical quality initiatives such as patient rosters and HEDIS
• Supports: value based care KPIs, Health Plan operations, regulatory requirements, Medicaid, Medicare, and commercial populations.
• Supports Interoperability, Clinical Quality, Care Management, Analytics and Reporting and Risk Management initiatives.

Responsibilities:

• Act as a quality consultant and subject matter expert, performing testing and validation of the mapping of data elements to standards.
• Performs discovery and can efficiently analyze large data sets identifying gaps.
• Collaborates with technical resources to perform root cause analysis and complete remediation of data quality issues.
• Works with customers to clarify and plan for their current and futuretechnology needs. Determines and maps existing business processes/functions and recommends changes required to fit a tightly integrated system.
• Designs and implements projects requiring systems integration, small teams and multiple technical platforms.
• Conducts Return on Investment (ROI) and other financial analysis to support project funding/prioritization.
• Collaborates on driving improvement activities to achieve department and organizational goals.
• Coordinates with functional team to assure consistency and optimization of overall work product.
• Assumes a proactive role in driving improvement activities to achieve department and organizational goals to deliver value.
• Maintains current knowledge of industry and business process trends and is able to apply that knowledge to existing business processes.
• Provides subject-matter expertise of Health Ministry processes, policies and requirements in support of functional area process design, testing and implementation.
• Identifies opportunities for process improvement and makes recommendations that lead to improvements.
• Monitors task assignments to ensure they are performed on schedule, within intended scope and to a defined level of quality.
• Escalates process and project issues that cannot be resolved.

Requirements

Education:

• High School diploma equivalency with 2 years of cumulative experience OR Associate's
  degree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required.

Additional Preferences

• Prior experience working as a Population Health, Insurance, Claims, Revenue analyst in the Healthcare system.

• Must have a working knowledge of relational databases/database structures, SQL experience desired

• Must have a strong understanding of data collected and used in Rosters, Claims Processing, Eligibility, Health Insurance Exchanges, Billing Systems and Care Management Systems.

• Knowledge and experience with healthcare claims and billing workflows and clinical information systems.

• Bachelor or Masters degree in related health or finance field example informatics or bioinformatics.

• Complexity of work: Within the scope of job, requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.

• 3 years of experience is preferred.
• High school diploma/GED with 2 years of experience, or Associate’s degree, or Bachelor’s degree highly preferred.
• Must be able to work in a stressful environment.

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Why Join Our Team

When you join Ascension, you join a team of over 134,000 individuals across the country committed to a Mission of serving others and providing compassionate, personalized care to all. Our inclusive culture, continuing education programs, career coaches and benefit offerings are just a few of the resources and tools that team members can use to create a rewarding career path. In fact, Ascension spent nearly $46 million in tuition assistance alone to support associate growth and development. If you are looking for a career where you can grow and make a difference in your community, we invite you to join our team today.

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