Summary
Infinite Computer Solutions is a company that values contributions and promotes work flexibility, learning, and career development. As a Professional Business Analyst - Claims, you will support projects by analyzing business needs, documenting requirements, and liaising between business and technical teams to ensure technology changes align with client objectives.
Responsibilities
- Assist in planning and designing business processes; help formulate recommendations that improve and support client business activities
- Analyze and document client business requirements and processes for moderately complex projects, and communicate those requirements clearly to technical personnel
- Participate in client meetings and facilitate moderately complex discussions to gather and document requirements and explore potential solutions
- Develop and modify systems requirements documentation to meet client needs; independently document requirements for simple projects or assigned subsystems
- Participate in technical reviews and inspections to verify that the intent of a change is carried through each phase of the project
- Use business solutions and analytical tools, such as Excel and basic relational database concepts, to evaluate information and support recommendations
Skills
- Medical claim adjudication knowledge and experience across multiple payers
- Experience with creating functional requirements documentation like DSDs (Design Specification Document) and BRDs (Business Requirements Document)
- Configuration of claims related business rules based on policy, business, and technical requirements
- 2 to 5 years of experience in a Business Analyst, systems analyst, or related role working with information technology and functional business groups
- A bachelor's degree in a technical or business discipline, or equivalent combination of education and experience
- Intermediate knowledge of requirements determination, documentation, analysis, evaluation/validation, traceability, prioritization, and requirements change management
- Ability to decompose high-level information into detailed low-level information, and distinguish requests from needs and requirements from solutions
- Functional analytical, problem-solving, presentation, personal computer, and business solutions software skills
- Effective verbal and written communication skills, with the ability to build relationships, work collaboratively, and manage difficult client interactions professionally
- Experience working with business processes and process improvement concepts
- Experience with project and change management tools such as ALM, iTrace, or rTrace
- Experience developing structured user manuals, training documentation, business rules models, or requirements traceability
- Health Care, Health Insurance, Medicaid, MMIS, or claims-processing experience preferred, including familiarity with Institutional and Professional/Physician claim forms and related concepts such as Prior Authorization, Member, Provider, Long-Term Care, Inpatient, and Outpatient processing
Qualifications
Must Haves
- Medical claim adjudication knowledge and experience across multiple payers
- Experience with creating functional requirements documentation like DSDs (Design Specification Document) and BRDs (Business Requirements Document)
- Configuration of claims related business rules based on policy, business, and technical requirements
- 2 to 5 years of experience in a Business Analyst, systems analyst, or related role working with information technology and functional business groups
- A bachelor's degree in a technical or business discipline, or equivalent combination of education and experience
- Intermediate knowledge of requirements determination, documentation, analysis, evaluation/validation, traceability, prioritization, and requirements change management
- Ability to decompose high-level information into detailed low-level information, and distinguish requests from needs and requirements from solutions
- Functional analytical, problem-solving, presentation, personal computer, and business solutions software skills
- Effective verbal and written communication skills, with the ability to build relationships, work collaboratively, and manage difficult client interactions professionally
- Experience working with business processes and process improvement concepts
Nice to Haves
- Experience with project and change management tools such as ALM, iTrace, or rTrace
- Experience developing structured user manuals, training documentation, business rules models, or requirements traceability
- Health Care, Health Insurance, Medicaid, MMIS, or claims-processing experience preferred, including familiarity with Institutional and Professional/Physician claim forms and related concepts such as Prior Authorization, Member, Provider, Long-Term Care, Inpatient, and Outpatient processing
Benefits
- Working at Gainwell carries its rewards, including a premium on work flexibility, learning, and career development.
- Fully remote options from continental US locations only.
- Office hours for this position are 8:00 am to 5 pm mountain time.