Business Analyst (Claims), Senior Job at Acentra Health, McLean, VA

Wm41SHNYNVJwZHQ3WGJIMEYwcDJCcENuS2c9PQ==
  • Acentra Health
  • McLean, VA

Job Description

Company Overview

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Job Summary and Responsibilities

Senior Business Analyst (OFIN) to join our growing team.

Job Summary

Senior Business Analyst is responsible for analyzing business problems, identify gaps, and develop technical solutions involving complex information systems with no supervision for Provider Enrollment, Screening and Credentialing sub systems. This role involves managing requirement scope, determining appropriate methods on potential assignments, and serving as a bridge between information technology teams and the client through all project phases; provide day-to-day direction on State program activities.

Responsibilities


  • Works with customers on presenting technical solutions for complex business functionalities.
  • Possesses unwavering commitment to customer service and operational excellence.
  • Provides customer support through leading client demos and presentations.
  • Prioritizes and schedules work assignments based on the project plan, handling multiple tasks across project phases.
  • Creates and modifies Business Process Models.
  • Understands the overall system architecture and cross-functional integration.
  • Demonstrates in-depth knowledge of business analysis relates to Provider Enrollment, Maintenance and Screening to ensure high quality.
  • Demonstrates advanced expertise and contributes to the Business Analysis practice by publishing technology points of view through the creation of white papers.
  • Possesses in-depth knowledge and is well-versed in multiple functions or capabilities.
  • Uses cases, workflow diagrams, and gap analysis to create and modify requirements documents and design specifications.
  • Analyzes user requirements and client business needs, leveraging expert opinion and expertise.
  • Acts as the requirements subject matter expert and supports requirements change management.
  • Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.



Qualifications

Required Qualifications

  • Bachelor's degree with 7+ years of business analysis experience or master's degree with 5+ years of business analysis experience.
  • Minimum 5 years of experience on large complex project and domain knowledge of Medicare healthcare vertical.
  • Minimum 3 years of Lead Business Analyst experience on large complex projects.
  • Strong knowledge in Medicare policies and guidelines.
  • Strong knowledge in claims adjudication and validations.
  • Strong knowledge in Medicare Reimbursement methodologies.
  • Excellent Business Analysis Process (SDLC, documentation procedures) experience.
  • Excellent customer relation skills including presentation and meeting facilitation.
  • Experience facilitating and running customer facing requirements and design sessions.
  • Excellent requirements elicitation and validation skill
  • Strong knowledge and proficiency in SQL, plus high-level of technical and database knowledge.



Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Compensation

The pay range for this position is listed below.

"Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at

EEO Statement

EEO AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Pay Range

USD $95,360.00 - USD $119,200.00 /Yr.

#J-18808-Ljbffr

Job Tags

Local area,

Similar Jobs

BDS Dealer Pros

Automobile Detail technician Job at BDS Dealer Pros

 ...including washing, drying, wheel and tire cleaning, clay bar, polishing and protecting paint, leather cleaning and conditioning, upholstery cleaning, carpet cleaning, and paint correction. Promotes the company's image by uniformed personal appearance, conduct, and communication... 

SSP

Assistant Coffee Shop Manager Job at SSP

 ...Join Our Team as an Assistant Restaurant Manager in a dynamic airport restaurant environment!~$25.56 / hour ($19.66 / hour + $...  ...Comprehensive Benefits Package ~ Career Progression Opportunities ~ Coffee Shop Management Experience Required ~ Must be available for early... 

Visionist

Front End Software Engineer Job at Visionist

 ...Visionist has an exciting new opportunity for a Front End Software Engineer supporting an ELINT/EW...  ...enterprise system leverages popular web technologies, including RESTful services...  ...teams - Collaborate with back-end developers and test team - Collaborate with a... 

Shaanxi Ruisi Tongsheng Translation Service Co., Ltd.

AP History Teacher Job at Shaanxi Ruisi Tongsheng Translation Service Co., Ltd.

Native English speakerHas teaching experience in AP HistoryHas teaching experience in international schools 1. International School AP History, Chaoyang District, Beijing.2. Native English speakers3. Visas: Teaching tittle Z visa4. Gender: Not specified.5. Faculty... 

Pursuit Collection

Security Agent Job at Pursuit Collection

 ...provide dynamic guest service at the Windsong Lodge. As the Property Security, you will perform routine security checks to prevent fire,...  ...unique power to inspire and invigorate, our collection of hotels and lodges, recreational attractions, ground transportation services...