• Business Systems Analyst II

    Job Locations US-VA-Glen Allen
    Job ID
    2018-5032
  • About Us

    Don’t just find a job, find your WHY at a purpose-driven organization; discover a career at Virginia Premier.
    By blending quality benefits, affiliating with the world-renowned VCU Health System and offering career-advancing development programs, we allow our employees to focus on the meaningful work of improving and saving the lives of more than 200,000 people throughout the state of Virginia.
     
    At Virginia Premier, we are building an industry leading health care organization through dedicated teams that have heart, provide top-notch quality member services and embrace our mission of inspiring healthy living within the communities we serve. Our vision is to connect people to innovation, quality and affordable health care for all phases of life.
     
    If this sounds like you, read on!

    Overview

    The Business Systems Analyst II is responsible for developing an extensive expertise in the core claims adjudication system and all interface applications, both customized and packaged that support coverage of services and provider reimbursement by the organization.  The positon is responsible for coordinating the maintenance of assigned Claims Department systems for the program and analyzes business requirements and objectives towards determining the optimal configuration of the requirements. The Business Systems Analyst II will play a key role in the design of new configuration requirements, issue resolution, and support of departmental initiatives.

     

    In addition, the Business Systems Analyst II may be the primary contact for one or more claims system interface applications and is expected to provide a high level of expertise with matters relating to this interface and its functionality and may work closely with the Team Lead or Manager to define and prioritize projects.

     

    Responsibilities

    • Perform complex cost analysis to determine impact of system changes and updates
    • Perform complex data analysis to identify trends Initiate complex auto reprocess claims
    • Initiate complex claims auto-reprocessing efforts
    • Facilitate project activity (coordinate follow-up, project planning and serve as subject area expert)
    • Perform root cause analysis to resolve claim payment discrepancies and system or process inefficiencies
    • Initiate process improvement and automation from concept to implementation
    • Initiate post-implementation test development
    • Identify solutions to data issues/complex data manipulation
    • Create quality and exception reports to audit the integrity of the data
    • Create complex test cases to validate system configuration or updates
    • Create and manage complex business process workflows
    • Work with customers to resolve system issues

    Qualifications

    MINIMUM EDUCATION REQUIREMENTS

    • Bachelor’s Degree in Computer Science, Information Systems, Business or related technical field.

    SPECIAL KNOWLEDGE AND/OR SKILLS 

    • Proficient knowledge of SQL queries to include ability to create and populate databases, perform data normalization, create query analysis, conduct table indexing, performing multiple table joins, and comfortable usage of functions (average, count, max, min, etc.)
    • Proficient knowledge of Microsoft Excel to include comfortably utilizing functions, developing charts and graphs, inserting formulas, performing VLOOKUP, and sorting and filtering data
    • Proficient knowledge of flow charting/process mapping
    • Knowledge of healthcare claims system
    • QNXT experience Preferred

    WORK BACKGROUND/EXPERIENCE 

    • 2+ year’s business experience possibly including Claims or Healthcare related experience(Preferably Medicaid Managed Care or Medicare)
    • 2+ years’ experience working in Information Systems (software installation, system configuration, SQL/Oracle platforms); data analysis
    • 2+ years’ experience writing TSQL or SQL queries

    PHYSICAL REQUIREMENTS

    • Physical health sufficient to meet the ergonomic standards and demands of the position.

    All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

     

    Our mission is to inspire healthy living within the communities we serve!

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