Claims Business Analyst
CentivoEmployer Health company
RemoteMid
Bain Capital Ventures
Bessemer Venture Partners
F-Prime Capital Partners
Maverick Ventures
Ingleside Investors
Rand Capital
Operations & Strategy
About the role
TL;DR
Analyze claims operations, lead projects, and improve efficiency using data and system knowledge.
- •As a Claims Business Analyst, you will be responsible for triaging operational issues and leading projects and tasks to completion.
- •You will use your claims adjudication experience and TPA background to triage operational concerns, vendor issues, and related claims issues.
- •Key Responsibilities Support the Centivo Claims Team with troubleshooting issues, identifying the root cause and magnitude, and then researching and recommending the best solution.
- •Develop and maintain advanced reporting, dashboards, KPI’s and business insights to support operational decision-making.
- •Function as a liaison between business and technical resources to ensure people, processes, and solutions meet or exceed the needs of our Clients and Operational areas.
- •Pull and analyze daily, weekly, and monthly operational reports to support Claims Operations, monitor team performance, identify trends, and provide actionable insights to leadership.
- •Proactively identify opportunities and recommend system solutions that increase automation, resolve system deficiencies, and enhance claims processing and reporting.
- •Requirements At least 5 years of experience within healthcare claims. 3 years of experience working as a Business Analyst.
- •Prior experience with highly automated and integrated claim adjudication systems.
- •Understanding of health insurance benefits administration in a self-funded environment.
- •Advanced problem-solving skills, with a track record of researching and resolving operational issues accurately and on time.
Required skills
SQLExcelJiraBusiness Operations
Nice-to-have skills
Tableau
Domain expertise
healthcare
Tech stack
SQLExcelJiraTableau
