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BA Claims - CREQ198551
Description
Role Summary
This job takes the lead in providing more complex application development services typically as part of a project team or in an application support role. Developers analyze, design, code, test and implement more complex systematic solutions to meet customer requirements that adhere to Thryve IT standards and policies. Developers provide general support to maintain more complex applications that meet the service levels, system availability, performance and quality levels required by their customers. May mentor less experienced team members.
Essential Responsibilities
Takes a lead role for analyzing, solutioning and implementing more complex application enhancements, as well as providing general production support, meeting defined scope, target dates and budgets with minimal or no defects.
Utilizes and participates in the more complex full system development life cycle, per current Thryve SDLC standards.
Takes a lead role in collaborating with customers, partners, and IT team members to understand business requirements that drive the analysis and design of quality technical solutions. Concentrates on providing innovative solutions to more complex business needs.
Takes a lead role in providing required business analysis support, including release implementations, on-call and supports when necessary.
Performs work in compliance with all Thryve IT standards, policies and procedures.
Effectively communicates with team members, customers, partners and management, including assisting with or conducting more complex technical walkthroughs, reporting project status, enabling vendor solutions and providing accurate and concise documentation.
Other duties as assigned or requested.
Required
Bachelor or Master degree in Information Technology or related field or years of related and progressive experience in lieu
Candidate must have worked in US healthcare with experience minimum of years, especially in claims application as business analyst or consultant
FEP, ITS Interplan Teleprocessing system Blue card claims and B2 application knowledge experience is preferable
Work experience in EHR EMR is also considered, but must have worked or possess knowledge of claims submission to Payers
Should have knowledge in working with all types of claim medical, hospital, Pharmacy, Dental, Vision, Blue card ITS etc.
Should have sound knowledge in claims testing end to end, work under minimal supervision and take complete ownership of delivery
Sound knowledge of current US federal and state laws with regards to healthcare governance and policies, and preferable to have PAHM FAHM certifications or working towards certification
Preferable to have basic SQL knowledge
Business Analysis knowledge is mandatory, and preferable to have certifications like CBA CBAP or working towards certification
Should have experience in writing functional specification documents BRD
Should have the fundamentals of requirement gathering, elicitation, documenting, and transition over to internal and external stakeholders
Should have ability to solve the complex business problems and exposed to complete software development life cycle SDLC)
Enthusiastic to learn and willing to work in flexible timing, and may require to work on weekend as per business need
This job takes the lead in providing more complex application development services typically as part of a project team or in an application support role. Developers analyze, design, code, test and implement more complex systematic solutions to meet customer requirements that adhere to Thryve IT standards and policies. Developers provide general support to maintain more complex applications that meet the service levels, system availability, performance and quality levels required by their customers. May mentor less experienced team members.
Essential Responsibilities
Takes a lead role for analyzing, solutioning and implementing more complex application enhancements, as well as providing general production support, meeting defined scope, target dates and budgets with minimal or no defects.
Utilizes and participates in the more complex full system development life cycle, per current Thryve SDLC standards.
Takes a lead role in collaborating with customers, partners, and IT team members to understand business requirements that drive the analysis and design of quality technical solutions. Concentrates on providing innovative solutions to more complex business needs.
Takes a lead role in providing required business analysis support, including release implementations, on-call and supports when necessary.
Performs work in compliance with all Thryve IT standards, policies and procedures.
Effectively communicates with team members, customers, partners and management, including assisting with or conducting more complex technical walkthroughs, reporting project status, enabling vendor solutions and providing accurate and concise documentation.
Other duties as assigned or requested.
Required
Bachelor or Master degree in Information Technology or related field or years of related and progressive experience in lieu
Candidate must have worked in US healthcare with experience minimum of years, especially in claims application as business analyst or consultant
FEP, ITS Interplan Teleprocessing system Blue card claims and B2 application knowledge experience is preferable
Work experience in EHR EMR is also considered, but must have worked or possess knowledge of claims submission to Payers
Should have knowledge in working with all types of claim medical, hospital, Pharmacy, Dental, Vision, Blue card ITS etc.
Should have sound knowledge in claims testing end to end, work under minimal supervision and take complete ownership of delivery
Sound knowledge of current US federal and state laws with regards to healthcare governance and policies, and preferable to have PAHM FAHM certifications or working towards certification
Preferable to have basic SQL knowledge
Business Analysis knowledge is mandatory, and preferable to have certifications like CBA CBAP or working towards certification
Should have experience in writing functional specification documents BRD
Should have the fundamentals of requirement gathering, elicitation, documenting, and transition over to internal and external stakeholders
Should have ability to solve the complex business problems and exposed to complete software development life cycle SDLC)
Enthusiastic to learn and willing to work in flexible timing, and may require to work on weekend as per business need
Primary Location
Chennai, Tamil Nadu, India
Job Type
Experienced
Primary Skills
Business Consulting-Foundational, Operations Management
Years of Experience
8
Travel
No
Job Posting
05/09/2024
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