Business Analyst III - Claims Processing

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Job description

OverviewThe purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health's Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.ResponsibilitiesThe Business Analyst III serves as an internal consultant and subject matter expert for the claims and call center operational teams. They provide detailed analysis and evaluation of metrics, reporting and data requirements. They will perform quality checks to confirm positive data integrity of reports, dashboards, and data extracts. When data anomalies are identified, the Business Analyst III collaborates with cross-functional teams to correct and provide accurate, actionable information. As the internal consultants, the Business Analyst III develops relationships with key stakeholders to understand the business needs and bridge the gap with various cross-functional departments, identifying opportunities to improve, develop, maintain and continuously monitor business performance.QualificationsMinimumThe Business Analyst III provides ongoing, complex support and analysis for DHMSO markets. Direct interaction with external stakeholders to review financial data/analysis. Identify opportunities within the department and provide/suggest solutions for improvement within the department in regards to data analysis. 5-7 years of industry experience working in a role requiring knowledge and management of Claims Data.High school diploma and/or GED required. Bachelor's Degree - Bachelor's degree in Computer Science, Mathematics, Management Information Systems, or a closely related field required. Or equivalent work related experience.Minimum three years' experience working in administrative senior level support position. Preferred3 years of experience with 834-837 Transaction Sets, QNXT, SQL, and SSIS.Previous experience with Healthcare Analytics. Previous utilization of Tableau.achelor's Degree in Business, Health Administration or related field preferred. MBA/ Master's