Senior Business Systems Analyst - Revenue Cycle and Claims

2 Months ago • 2-3 Years
Business Analysis

Job Description

This role involves working with stakeholders to define data needs, mapping revenue cycle, clinical, and claims data to a normalized model, and serving as a subject matter expert on revenue cycle data domains. Responsibilities include quality consulting, testing data mapping, root cause analysis of data quality issues, planning technology needs, designing system integration projects, and conducting financial analysis. The analyst will also drive improvement activities, maintain industry knowledge, and provide expertise on Health Ministry processes.
Good To Have:
  • SQL experience
  • 3 years of experience
Must Have:
  • Works with stakeholders to discover, clarify, and document current and future data needs.
  • Performs mapping of revenue cycle, clinical and claims data to a normalized data model.
  • Serves as a subject matter expert on revenue cycle data domains.
  • Builds data concepts to supports Revenue Cycle and Claims use cases.
  • Acts as a quality consultant and subject matter expert, performing testing and validation of data mapping.
  • Collaborates with technical resources to perform root cause analysis and complete remediation of data quality issues.
  • Works with customers to clarify and plan for their current and future technology needs.
  • Designs and implements projects requiring systems integration, small teams and multiple technical platforms.
  • Conducts Return on Investment (ROI) and other financial analysis.
  • Collaborates on driving improvement activities to achieve department and organizational goals.
  • Coordinates with functional team to assure consistency and optimization of overall work product.
  • Maintains current knowledge of industry and business process trends.
  • Provides subject-matter expertise of Health Ministry processes, policies and requirements.
  • Identifies opportunities for process improvement and makes recommendations.
  • Monitors task assignments to ensure they are performed on schedule, within scope and to quality.
  • Escalates process and project issues that cannot be resolved.

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Description

Job Summary:

  • Works with stakeholders to discover, clarify, and document current and future data needs
  • Performs mapping of revenue cycle, clinical and claims data to a normalized data model.
  • Serves as a subject matter expert on the revenue cycle data domains such as Registration, Scheduling, Accounting and Billing
  • Builds data concepts to supports Revenue Cycle and Claims use cases
  • Serves as a key resource for an assigned customer area to understand and explain business and technical issues and to provide viable technology solutions.

Responsibilities:

  • Act as a quality consultant and subject matter expert, performing testing and validation of the mapping of data elements to standards
  • Collaborates with technical resources to perform root cause analysis and complete remediation of data quality issues
  • Works with customers to clarify and plan for their current and future technology needs. Determines and maps existing business processes/functions and recommends changes required to fit a tightly integrated system.
  • Designs and implements projects requiring systems integration, small teams and multiple technical platforms.
  • Conducts Return on Investment (ROI) and other financial analysis to support project funding/prioritization.
  • Collaborates on driving improvement activities to achieve department and organizational goals.
  • Coordinates with functional team to assure consistency and optimization of overall work product
  • Assumes a proactive role in driving improvement activities to achieve department and organizational goals to deliver value.
  • Maintains current knowledge of industry and business process trends and is able to apply that knowledge to existing business processes.
  • Provides subject-matter expertise of Health Ministry processes, policies and requirements in support of functional area process design, testing and implementation
  • Identifies opportunities for process improvement and makes recommendations that lead to improvements
  • Monitors task assignments to ensure they are performed on schedule, within intended scope and to a defined level of quality.
  • Escalates process and project issues that cannot be resolved

Experience:

  • Prior experience working as a Revenue Cycle analyst in the Healthcare system.
  • Must have a working knowledge of relational databases/database structures, SQL experience desired
  • Must have a strong understanding of data collected and used in EMRs, Revenue Cycle and Patient Accounting Systems.
  • Knowledge and experience with ambulatory and acute clinical, billing and claims workflows and clinical information systems.
  • Bachelor or Masters degree in related health or finance field ex informatics or bioinformatics.
  • Complexity of work: Within the scope of job, requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment.
  • 3 years of experience preferred
  • High school diploma/GED with 2 years of experience, or Associate’s degree, or Bachelor’s degree require

Work Environment

This job operates in a professional office environment. This role routinely uses standard office equipment, including but not limited to, computers, phones, and photocopiers.

Physical Demands

This position requires the frequent and repetitive use of a computer, keyboard, and mouse. Hand and finger dexterity is required.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

EEO

Saama provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

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