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Business Analyst II

Company: Elevance Health
Location: Indianapolis
Posted on: May 12, 2024

Job Description:

Business Analyst II
Location : This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.
The BUSINESS ANALYST II is responsible for identifying, analyzing, and validating overpayment recovery opportunities, translating moderately complex and varied business needs into business cases or business requirements document (BRD) to create data mining queries that will contribute to cost of care savings.
How you will make an impact:

  • Analyzes business needs to determine optimal means of meeting those needs.

  • Assessing overpayment opportunity by reviewing low to high volume claim samples.

  • Accessing provider contracts, company claims policy and coding guidelines to support recovery opportunity.

  • Works with programming staff to ensure requirements will be incorporated into concept design and testing of claims identified as potential overpayments.

  • Collaborating with Query Developers, business owners and Business Consultants.

  • Collaborates with the claims validation team to approve concepts for recovery.

  • Identify process improvement opportunities that result in increased savings.

  • Consults with business partners concerning processes, procedures, contracts, processing rules and other system rules to identify overpayments.

  • Obtains, interprets, and applies provider and member contract language to the creation of BRDs (business requirement documents) that contribute to CoC.

    Minimum Requirements:

    • Requires a BA/BS and minimum of 3 years related business analysis experience, or any combination of education and experience, which would provide an equivalent background.

      Preferred Skills, Capabilities and Experiences :

      • WGS claims processing/adjusting experience strongly preferred.

      • Project management and MS Excel experience preferred.

      • Ability to manage multiple projects in various stages to completion preferred.

      • In-depth knowledge of claims processing, reimbursement policies and procedures strongly preferred.

      • Strong analytical and problem-solving skills with research-oriented approach preferred.

      • Strong written, verbal, and interpersonal communication skills preferred.

        For candidates working in person or remotely in the below locations, the salary* range for this specific position is $60,984 to $104,544
        Locations: Colorado & Nevada
        In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws .

Keywords: Elevance Health, Indianapolis , Business Analyst II, Professions , Indianapolis, Indiana

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