Development and communication of claims system definition related to new product initiatives, upgraded or enhanced core system functionality, changes to existing products or reimbursement methodologies and compliance with regulatory mandates. Develop project business requirements based on new and revised claims operations initiatives. Act as a claims system and process expert in support of IHA service operations. Act as a liaison between claims operations staff, IT technical staff and other organizational departments.
Bachelor’s degree in Business Administration. Minimum of 5 years health insurance experience may be considered in lieu of degree.
Three years business analyst experience preferred. Minimum of 5 years health insurance operations experience may be considered in lieu of business analyst experience.
Superior systems skills including PowerMHS, AS400 query, MSAccess, Word and Excel.
Demonstrated ability to provide detailed data analysis and facilitate operations system development and enhancement.
Ability to relate operational activities to corporate strategic initiatives.
Capacity to facilitate meetings; full cycle project exposure and/or project management experience.
Proven problem solving track record with high level attention to detail with demonstrated ability to meet project deadlines.
Excellent verbal and written communication skills with the capacity to provide customer service support for members, providers and employers.
Ability to work overtime and holidays is required and a condition of employment.
Proven examples of displaying the IH values: Passion, Caring, Collaborative, Respectful and Accountable.
Maintains confidentiality and uses only the minimum amount of protected health information (PHI) necessary to accomplish job related responsibilities.
Other duties as needed. Every associate is given a job description upon hire outlining the qualifications, duties, and pay grade of the position. Independent Health reserves the right to change job descriptions as necessary.
Independent Health is an equal opportunity employer.