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Business Analyst/ SME Healthcare (Billing)

Bengaluru, KA
Job Code:
  • IT
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Job Details

Expertise in business management, training, technical support and customer service for claimsAbility to analyze issues, expedite solutions.Capable of analyzing volumes of functional information and then conceiving realistic solutions that bridge the gap between technology limitations and increase successful claim submission rate.Proven team leadership strengths, excellent listening, written and oral communications skills and the ability to interact professionally with diverse groupsExcellent training and documentation abilitiesTroubleshooting / Problem-solving / Issue Resolution will be an added advantage for this positionFunctional RequirementExtensive knowledge with Claims cycle both with eClaims & paper claims as wellExperienced in writing/configuring business rules to reduce the claim denialsHands on experience with maintaining dynamic charge prices based on Fee schedules & managed contracts as wellWorking knowledge on the process involving EOB, claims reconciliation, distributing the ERAs among different services under one / more claimsDetailed breakdown of claims with different claim statusesAP/AR entry with cross footing flows to GL financial statementsAnalytical Reporting AR/AP Financial class reports , Aging reports, patient wise summaries & day sheetsClaims Dashboards for status checks , eligibility checks, pre authorizationsWorked at least on a billing solution for minimum of 3 years in one or more projectsIts added advantage if you have been part of any billing end-end development/implementation as analyst owning or delivering the requirementsOthersStrong skills using any integration engines to submit claims either to payers or to clearing houses. Good to have skillsHave QA exposure in terms of user acceptance testing,Familiar with change management processKnowledge on reporting systems like Crystal Reports, Business Intelligence, etc
Additional Degree: BE/ B.Tech (Engineering)

Experience: 6-10


Application Programming | Database Administration (DBA) | Graphic Designing/Animation/Web Designing | Software Engineer
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