Position: Business Analyst Healthcare
Location: Parsippany, NJ (Hybrid – need to travel to client place twice in a week)
Duration: Full Time
Job Description:
Overview: As a Healthcare Business Analyst specializing in claims processing and pre-authorization, you will play a critical role in optimizing the development of our products. Your expertise will contribute to efficient claims management, accurate pre-authorization decisions, and streamlined processes.
Responsibilities:
- Analyze end-to-end claims workflows, from submission to payment.
- Collaborate with stakeholders (insurers, providers, patients) to identify process improvements.
- Understand how to Ensure compliance with industry standards (e.g., HIPAA)
- Evaluate pre-authorization requests for medical services or procedures.
- Verify medical necessity and adherence to guidelines.
- Facilitate timely approvals by working closely with providers and payers.
- Utilize tools like Excel, SQL, and data visualization platforms.
- Create reports, dashboards, and presentations to communicate insights.
- Monitor performance metrics related to claims and pre-authorization.
- Collaborate with IT teams to enhance products and development of claims processing systems.
- Gather requirements for system upgrades and new features.
- Maintain strong communication with cross-functional business units.
Regards,
Manoj
Derex Technologies INC
Contact : 973-834-5005 Ext 206
Additional information
All your information will be kept confidential according to EEO guidelines.
Derex Technologies Inc
Derex Technologies Inc specializes in providing IT consulting, staffing solutions and software services
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