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Associate Technical Business Analyst

72% Flex
Remote: 
Full Remote
Contract: 
Full time
Work from: 
United States

Offer summary

Qualifications:

Prefer a Bachelor's degree in business administration, health planning and administration, information systems, computer science; 3 years' experience., Familiarity with health care industry, Facets system, claims processing, and application configuration..

Key responsabilities:

  • Support core functional system applications. Use detailed business requirements for changes.
  • Lead medium-scale department projects, identify risks, Elicit/documented detailed business needs.
  • Serve as an expert for 2 business processes.
  • Facilitate meetings, summarize analytical research, perform application testing.
  • Review and communicate testing defects effectively for correction.
Capital Blue Cross logo
Capital Blue Cross Insurance Large https://www.capbluecross.com/
1001 - 5000 Employees
About Capital Blue Cross
Capital Blue Cross fosters an inclusive culture because we know that recognizing and embracing diversity leads to greater thoughtfulness, empathy, and innovation in meeting the needs of our employees, our members, and the communities we serve. Our employees are encouraged to bring their authentic perspectives and experiences into the workplace, allowing for an environment where different viewpoints can fuel positive change and growth. We want to help each member of our team grow both personally and professionally, and know that their health and well-being are as important as any corporate goal. We are committed to honoring and promoting greater understanding and progress related to diversity and inclusion. We do this in part through an active Diversity, Equity, and Inclusion Council - a cross-functional group of employees who examine issues and recommend improvements that will impact our workplace and our communities. To increase employee engagement and provide opportunities for networking, learning, career development, and community outreach, Capital also has several Employee Resource Groups. These voluntary groups, which are open to all employees, include: Blacks United in Legacy Together (BUILT), which supports recruiting, onboarding, and retention of Black employees and advocates for the unique needs and opportunities for Black employees. Latinos Unidos Network Azul (LUNA), which helps recognize the rich culture and unique perspective of the Latino community. Women's Impact Network (WIN), which helps foster relationships and accelerate personal and professional growth among women employees. Our goal is to involve all employees in helping us to create a culture of acceptance, understanding, and growth. Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley.
See more Capital Blue Cross offers

Job description

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Position Description

Provides analytical, technical and problem resolution support to core (Facets) and peripheral systems with a focus on claims. Conducts or participates in activities related to planning, controlling and directing, and performing system enhancements/projects, testing processes and/or system changes and configuration/support. The analyst must use knowledge of existing business practices, systems, procedures, policies, current testing tools/practices and their inter-relationships to provide and ensure innovative approaches and solutions to business problems and requirements in the supported systems. The analyst is responsible for obtaining necessary approvals on systems configuration, systems testing and application changes.

Responsibilities And Qualifications

Duties and Responsibilities:

  • Supports core functional system targeted applications and tasks. Includes understanding of end to end process. Demonstrates the ability to create and run simple queries. Includes all previous grade level expectations.
  • Ability to serve as a department project lead for medium scale (40-500 hours) department/corporate projects and/or maintenance activities as assigned. Includes the ability to communicate project team status updates verbally and in writing to all team members. Ability to identify potential projects risks and contingencies. Consider root cause analysis and identify process improvement opportunities.
  • Ability to elicit and/or document detailed business requirements to support configuration and system changes.
  • Understand end to end processes and downstream impacts when system and process changes occur. Organizes information and data to identify and explain major trends, problems, and causes. Includes all previous grade level expectations.
  • Serve as a subject matter expert for two (2) business processes and technical detailed knowledge.
  • Responds to questions from internal and external customers.
  • Ability to summarize verbally and in writing advanced analytical research that is understandable to the intended audience. Ability to facilitate meetings including preparing agendas, minutes, and other documentation as needed. Communicate any roadblocks or impacts to both management and business areas.
  • Performs application testing for maintenance and medium scale (40-500 hours) projects. Ability to write test plans, setup test data, execute test scenarios and document defects. Review and coordinate testing with business areas. Communicate test status and milestones to dept and project management. Serve as a test lead on projects. Evaluate and effectively communicate testing defects and negative business impacts to ensure they are being addressed with a sense of urgency.
  • Skills:
  • Ability to lead meetings and give presentations to both management and staff. Includes the ability to develop teamwork among diverse groups.
  • Ability to analyze problems and issues, determine impact, and develop business solutions for system changes. Ability to act as a liaison and recommend solutions to a variety of departments, as well as other Plans and other external business partners.
  • Ability to plan, organize, lead and control projects. Includes the ability to effectively communicate in writing and verbally with technical and non-technical audiences. Also includes persuasion and negotiation skills to resolve differences with skill and understanding.
  • Ability to quantify and prioritize assigned activities, the ability to adapt to changing priorities, and perform duties with minimal supervision. Includes ability to act both independently and as part of a team.
  • Ability to review, build, create mapping documentation, partner with developers, recommend changes, and analyze requests specific to standard EDI X12 claim transactions (837, 835).

Knowledge

  • Knowledge of the health care industry and CBC corporate structure. Includes knowledge of standards, policies, and business practices and procedures for multiple departments/systems. Is familiar with those business services, systems and/or processes provided by external business partners.
  • Knowledge of data processing terminology and concepts. Includes a high- level technical understanding of technologies such as Microsoft Office Suite, Crystal Reporting, Data Modeling and Intranet Technology as well as knowledge of batch and real-time processing environments. Also includes knowledge of online change methodologies (i.e. Remedy), Quality Center and Web-Based Products. Experience working with testing tools, such as HP WinRunner/QTP, and LoadRunner, especially for regression testing and performance measurement.
  • Knowledge of ANSI Standards as they relate to HIPAA legislation.

Knowledgeable and capable of conducting cost benefit analysis techniques.

Experience

  • Prefer a Bachelor's Degree in one of the following; business administration, health planning and administration, information systems, computer science; and three years' relative experience.
  • Experience working with an integrated business system that handles claims processing, membership, billing, network, clinical, customer service, and product processes.
  • Experience working with application configuration of systems
  • Familiar or experienced in any of the peripheral systems to Facets.

Education And Certifications

  • Prefer a Bachelor's degree in one of the following: business administration, health planning and administration, information systems, computer science; and three years' relative experience.

Physical Demands

While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see. The employee must be able to work over 40 hours per week. The employee must occasionally lift and/or move up to 5 pounds. Sedentary work involving significant periods of sitting, talking, hearing, keying and performing repetitive motions. Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor. Working environment includes typical office conditions.

Other

Travel

  • Travel may be required and could potentially include overnight excursions.
  • Ability to communicate effectively with all levels of personnel, both internal and external.
  • Ability to communicate technical information in an easy to understand yet comprehensive manner for various business areas.

Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association. We are an equal opportunity/affirmative action employer and do not discriminate on the basis of race, color, religion, national origin, gender, sexual orientation, gender identity, age, genetic information, physical or mental disability, veteran status, or marital status, or any other status protected by applicable law.

Required profile

Experience

Industry :
Insurance
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Hard Skills

Crystal ReportsData ModelingData SystemsLoadRunnerProject PlanningBusiness Systems AnalysisCost AnalysisHospital Industry KnowledgeTool ProficiencyMS OfficeQuality Control

Soft Skills

  • Excellent Communication
  • Leadership
  • Analytical Thinking
  • Proactive Mindset
  • Negotiation Techniques
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