Business System Analyst II

1199SEIU Family of Funds - New York, NY3.9

Full-timeEstimated: $74,000 - $98,000 a year
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EducationSkills
Responsibilities

Design, test and implement new configurations for claims system to efficiently adapt claims adjudication applications to changing regulatory requirements, new reimbursement and benefit structures in a cost effective manner adapt
Perform systems requirements, design and test internally developed applications, interfaces and analytical reports
Draft PDRs (Product Design Requirements) schedule testing and deployment of new releases for vendor applications; shape vendors’ strategy for applications’ growth to accommodate the Funds’ needs, goals, and regulatory requirements; ensure timeliness of major upgrades
Liaise with Claims, Provider Relations, Eligibility, Care Management and Member Services Directors and Assistant Directors, vendor account managers and other technical resources for internal software development; respond to user’s and trading partner’s issues; advocate for Funds regarding anomalies in vendor applications
Maintain tracking database for outstanding issues and vendor anomalies to ensure vendors and Information Technology (IT) department resources are accountable to operational areas and external trading partners (i.e., providers, clearinghouses, care management vendors)
Supervise Business Analysts in responding to requests from staff; ensure new fee arrangements, modify benefits, messaging, etc. are correctly configured to meet requestor’s needs
Participate in Application User Groups and Industry Associations gatherings
Perform additional duties and projects as assigned by management

Qualifications

Bachelor's degree or equivalent years of work experience required
Minimum two (2) years experience as a Business Analyst, to include one (1) claims processing experience required
Demonstrated experience working with clinical editing software and writing systems specifications
Intermediate skill-level Microsoft Excel required
Knowledge of medical, hospital and dental claims processing
Knowledge of relational database concepts and facility with SQL (Structured Query Language); ability to write multi-table queries; correlated sub-queries
Excellent analytical, problem solving verbal and written communication skills
Ability to prioritize work with tight schedules and target dates
Demonstrated organizational skills with ability to multi-task and follow up
Ability to work independently and as a team player