Senior Business Systems Analyst - Claims and Revenue Cycle

Ascension; United States; Remote; USD 50,000 - 90,000; Full time

Job summary

Join a forward-thinking organization dedicated to improving healthcare through data-driven insights. As a key player in the Data Delivery Governance team, you will leverage your expertise in data analysis and healthcare systems to support critical initiatives. This role involves collaborating with stakeholders to ensure data quality and integrity while driving improvements in healthcare processes. With a commitment to personal and professional growth, this innovative firm offers a supportive environment where your contributions will make a significant impact on patient care and operational efficiency. Embrace the opportunity to grow your career in a mission-driven organization.

Benefits

Paid Time Off (PTO)

Health Insurance Options

Retirement Benefits

Tuition Reimbursement

Employee Assistance Programs

Parental Leave

Adoption Assistance

Qualifications

• 2 years of cumulative experience or equivalent education required.
• Knowledge of healthcare claims and billing workflows is essential.

Responsibilities

• Collaborate with stakeholders to document data needs and perform mapping.
• Act as a quality consultant, validating data mappings to standards.

Skills

Data Analysis

SQL

Critical Thinking

Healthcare Knowledge

Project Management

Education

High School Diploma

Associate's Degree

Bachelor's Degree

Master's Degree

Tools

Relational Databases

Claims Processing Systems

Billing Systems

Job description

We Are Hiring

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

What You Will Do

• 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.

What You Will Need

Education:

• High School diploma equivalency with 2 years of cumulative experience OR Associate'sdegree/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.

Equal Employment Opportunity Employer

Ascension will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws.

For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.

As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.

Pay Non-Discrimination Notice

Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.

E-Verify Statement

This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.E-Verify

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.