Under the general supervision of the Application Supervisor, the Jr.Business Analyst responsible for identifying and documenting business processes through clients interview and reviewing and analyzing existing claims processing system needs. The Jr.Business Analyst configures and maintains provider contracts, fee schedules and code sets in the claims adjudication system. Additionally, this position provides technical and administrative support to operational areas to ensure that system configuration and data is precise and ready to support the operational and business needs of Alameda Alliance for Health (the “Alliance”) and its various business partners.
· Analyze, design, test and develop system configuration needs to include documentation, adherence to change management standards and requirements, and preparation of work plans that deliver on schedule and within scope.
· Accountable for in-depth understanding of business/operational workflows and detailed understanding of new workflow objectives and knowledge of how the enterprise software application functionality will support new workflows.
· Work with the business for the purpose of analysis and documentation of business needs and requirements.
· Responsible for researching and troubleshooting software and workflow issues to understand software build steps needed for production environment of business application.
· Configure provider contracts and fee schedules in the claims adjudication system. Also, maintain and monitor updates of various code sets to ensure accurate and timely operations.
· Ability to extract and synthesize data; and conduct and interpret quantitative and qualitative analyses.
· Test application configurations, work flow and builds or does unit testing in non-production environment and reports on outcomes noting issues. Corrects issues found in testing.
· Design, plan and conduct end user training in technical systems variety of software systems on desktop and laptop.
ESSENTIAL FUNCTIONS OF THE JOB
· Strong organizational skills that reflect ability to perform and prioritize multiple tasks seamlesslywith excellent attention to detail.
· Highly resourceful team-player, with the ability to also be extremely effective independently.
· Performing writing, reporting, and analysis skills
· Communicating effectively and efficiently internally and externally.
· Complying with the organization’s Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls.
· Constant and close visual work at desk or computer.
· Constant sitting and working at desk.
EDUCATION OR TRAINING EQUIVALENT TO:
· Bachelor's Degree in Computer Science or Information Systems preferred or equivalent experience.
MINIMUM YEARS OF ADDITIONAL RELATED EXPERIENCE:
· Minimum 4+ years working as a business analyst working within the health care/managed care environment, preferably in business operations (e.g., claims) or in IT, or system configuration required.
SPECIAL QUALIFICATIONS (SKILLS, ABILITIES, LICENSE):
· Systems configuration experience with HealthSuite and/or equivalent managed care transition systems required.
· Strong interpersonal skills with ability to function in a self-directed work team.
· Ability to work effectively in a multidisciplinary team, providing leadership, guidance, information and stellar customer service.
· Experience gathering and documenting requirements.
· Experience developing test cases.
· Ability to extract and synthesize data and conduct and interpret quantitative and qualitative analysis.
· Experience with project management principles.
· Ability to plan and execute projects independently.
· Ability to communicate effectively, both verbally and in writing.
· Excellent organizational skills and orientation to detail.
· Intermediate level in Microsoft Visio, Project, Access, Excel, Outlook, and PowerPoint or equivalent database and reporting.