Business Analyst Operational Process Improvements
Omnicare - Cincinnati, OH

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Job Summary:
Review process outcomes and identify best practices. Major focus will be identifying Payer tendencies relative to claim transaction codes, and determining what proactive changes we can make to improve our positive adjudication rate.

Key Responsibilities:
  • Proactively identify and complete reports that indicate billing or processing errors.
  • Analyze claims data to validate our accuracy in claim submission as compared to payer expectations
  • Make recommendations to Billing and Operations team about process changes to improve positive adjudication rates
  • Analyze and summarize claims data and make inferences about field value impacts
  • Review system changes and determine the impacts those changes had on claims adjudication
  • Identify best practices to ensure regulatory and contractual compliance with third party payer
  • Ensure accuracy among pay plan set ups
  • Run reports on error rates in set up accuracy and report error rates to Sr. Director
  • Other duties as assigned
Minimum (Required) Qualifications: (must be met in order to perform the job at the required level)

  • Bachelor’s degree in business or healthcare related field or 1-3 years experience in the pharmaceutical or insurance industries
  • Demonstrates core competencies of: self-motivated, attention to detail, organization skills, ability to prioritize and follow up, effective communication and ownership for one’s work
  • Proficient in Microsoft Office including but not limited to: Excel and Access
Physical Demands: May sit, stand, stoop, bend and walk intermittently during the day. May sit or stand seven (7) to ten (10) hours per day. May be necessary to work extended hours as needed. Finger dexterity to operate office equipment required. May need to lift up to twenty-five (25) pounds on occasion. Visual acuity to see and read fine prints. Specific vision abilities required by this role include close vision, color vision and the ability to adjust focus. Must be able to hear normal voice sounds. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role.
Work Environment: Work in a climate-controlled, smoke-free internal environment.

Requirements

Minimum (Required) Qualifications: (must be met in order to perform the job at the required level)
  • Bachelor’s degree in business or healthcare related field or 1-3 years experience in the pharmaceutical or insurance industries
  • Demonstrates core competencies of: self-motivated, attention to detail, organization skills, ability to prioritize and follow up, effective communication and ownership for one’s work
  • Proficient in Microsoft Office including but not limited to: Excel and Access

Omnicare, Inc - 24 months ago - save job - copy to clipboard
About this company
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Omnicare, Inc., a Fortune 400 company based in Cincinnati, Ohio, provides comprehensive pharmaceutical services to patients and providers...