Business Analyst (Healthcare) - FULLY REMOTE

Job#: 2089669 Job Description: Apex Systems is hiring for a mid-level Business Analyst for a major Healthcare company. 4 month contract with potential to extend. FULLY REMOTE anywhere in the United States, EST/CST is preferred. You must be authorized to work in the United States without sponsorship. About the role: • Role will be documenting Duals Operating Model Requirements – from an HP Ops standpoint, seeking changes in claims, encounters, eligibility, + reviewing for changes and necessary change requirements. • This team works with other business teams – in pulling information across multiple documents; this will be a combination of independent and collaborative work. Education/Experience: Bachelors degree 4-6 years of business process or data analysis experience, preferably in Healthcare Medicare, Medicaid or Duals experience Technical Skills: • Experience with requirement documentation • Experience with health plan operations (claims, eligibility, encounters, call center) • Knowledge of Medicare / Medicaid Soft Skills: • Detail oriented, with an ability to understand the more technical side of Operations. Day to Day: • Claims are generally complex and require days for completion – there is no minimum per day requirements, etc. • Participating in meetings to ensure correct documents are noted. • Performance will be measured on completion, accuracy, and comprehensiveness. Benefits and Payment Configuration: Experience in benefits, pricing, contracting or claims and knowledge of provider reimbursement methodologies. Knowledge of managed care information or claims payment systems preferred. Previous structured testing experience preferred. Compliance Coding/Prepay Compliance (Payment Integrity) Experience in claims coding analysis or medical claim review/research preferred. Knowledge of Amisys claims payment system and Business Objects preferred. Encounters: Experience with encounters or claims business analysis experience in healthcare, preferably managed care or Medicaid. Knowledge of Amisys or other claims system, HIPAA transactions (i.e. 837, 999, 824, 277) and SQL Scripting preferred. Medicare Experience in managed health care experience, preferably with Medicare. Experience working with and leading diverse teams in matrix managed environments. Project management experience preferred. Provider Data: Knowledge of data migration, software enhancement/planning, and Agile preferred. Experience managing projects with a high reliance on technology. Member & Provider Solutions Experience managing projects with a high reliance on technology. Knowledge of data integration, software enhancements/planning and Agile preferred. • Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems • Identify and analyze user requirements, procedures, and problems to improve existing processes • Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations • Identify ways to enhance performance management and operational reports related to new business implementation processes • Coordinate with various business units and departments in the development and delivery of training programs • Develop, share, and incorporate organizational best practices into business applications • Diagnose problems and identify opportunities for process redesign and improvement • Formulate and update departmental policies and procedures • Serve as the subject matter expert on the assigned function product to ensure operational performance EEO Employer Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at [email protected] or 844-463-6178. Apex Systems is a world-class IT services company that serves thousands of clients across the globe. When you join Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRated's Best of Staffing® in Talent Satisfaction in the United States and Great Place to Work® in the United Kingdom and Mexico. Apex Benefits Overview: Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our ‘Welcome Packet’ as well, which an Apex team member can provide. Apex Systems is a world-class IT services company that serves thousands of clients across the globe. When you join Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRated's Best of Staffing® in Talent Satisfaction in the United States and Great Place to Work® in the United Kingdom and Mexico. Apex Benefits Overview: Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our ‘Welcome Packet’ as well, which an Apex team member can provide. Apex Systems is part of the Commercial Segment of ASGN Incorporated. NYSE: ASGN 4400 Cox Road Suite 200 Glen Allen, Virginia 23060 Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at [email protected] (Do not submit resumes or solicit consultants to this email address). UnitedHealthcare creates and publishes the Transparency in Coverage Machine-Readable Files on behalf of Apex Systems.