Job Summary

A health insurance company is in need of a Remote Business Analyst II or III in Miami.

Core Responsibilities Include:

• Translating basic to complex and varied business needs into business cases or business requirements documents (BRD) to create data mining queries that will contribute to cost of care savings and total program savings
• Performing WGS tasks in conjunction with the pre-pay initiative project for Datamining and Overpayments (DMO)
• Assessing overpayment opportunity by reviewing WGS claim samples

Qualifications Include:

• BS/BA degree, 5-7 years of business analysis experience that includes knowledge of systems capabilities and business operations; or any combination of education and experienced, which would provide an equivalent background
• Analysis, audit, project management, and WGS claims processing experience
• Intermediate skill level with MS Excel, pivot tables, formulas, V-lookup, etc
• Proven strong analytical and problem solving skills with research oriented approach
• Ability to manage multiple projects in various stages to completion
• Ability to develop Business Requirement Documentation and coordinate UAT and PNP documentation, involving those in and outside the business unit