Sr. Business Analyst - EDI

Nassau County, NY

Posted: 08/02/2018 Employment Type: Direct Hire Industry: Technology Job Number: 10183

Sr. Business Analyst
  • Status: Full Time
  • Salary Range: 120K
  • Remote Option: Available

Job Description:

A Healthcare company is presently looking for a Senior Business Analyst with extensive health care knowledge and is well versed in all IT lifecycle of analytical and technical processes from requirements gathering through programming and implementation.
  • Implement hospital, ancillary, provider contracts and client benefit contract coding into claim management system.
  • Perform all tasks of a business analyst at a consistently high level.
  • Perform quality assurance
  • Work with claim system vendor to implement new features and fixes
  • Independently manage multiple projects to satisfactory completion
  • Communicate with IT management on the progress of the various initiatives
  • Mentor/assist junior team members
  • Work closely with business users to identify business needs and document it.

Essential Qualifications:
  • 8+ years of progressive experience
  • Thorough knowledge of healthcare concepts which may include:
    • Industry terminology/concepts including: ICD, CPT, DRG, Revenue codes
    • Benefits configuration using Boolean logic
    • Accumulators
    • Health care provider reimbursements configuration including hospital and ancillary providers
    • Understanding of pricing and claim adjudication
    • COB pricing including Medicare rules
    • EDI knowledge
  • Communicate effectively with internal and external stakeholders
  • Must possess the ability to manage multiple projects with minimal supervision
  • Strong attention to detail and perform consistent work product validation/QA
  • Strong analytical skills

Technical Skills Desired:
  • Excel
  • Understanding of Software Development Life Cycle

  • Choice of HRA & PPO medical plans with RX coverage
  • Choice of PPO & HMO Dental Plans
  • Vision Plan
  • Short & Long Term Disability
  • Life Insurance 
  • Flexible Spending Accounts (Health & Dependent Care)
  • 401k with generous employer match
  • Profit-sharing retirement plan
  • Generous paid time off with holidays
  • Commuter benefits
  • Pet Insurance 



Sean Tomlinson

Fun Facts: World traveler, Avid beer collector, Amateur astronomer 

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