Location: Middleburg Heights, OH
Schedule:Hybrid (2 days onsite per week)
Department: Integrations Team / Application Development
Reports To: Director of Application Development
Range: $85k-$95k
Sponsorship: Not Available
Position Summary:
We are seeking a detail-oriented and technically proficient Technical Business Analyst with expertise in healthcare billing systems to join our team. This role will serve as a critical link between business stakeholders and IT, ensuring that billing processes are optimized, compliant, and aligned with organizational goals.
Key Responsibilities:
General Business Analysis
- Gather, analyze, and document business and technical requirements.
- Translate business needs into functional specifications and user stories.
- Conduct gap analyses and recommend process improvements.
- Facilitate stakeholder meetings to define project scope and objectives.
- Support QA and UAT efforts by validating test cases and outcomes.
Technical & Systems Analysis
- Analyze system capabilities and recommend enhancements.
- Create and maintain documentation including process flows, data models, and integration maps.
- Troubleshoot and resolve system issues related to billing workflows.
Healthcare Billing-Specific Functions
- Analyze and optimize workflows related to medical billing and client specific Use Cases.
- Knowledge regarding compliance with HIPAA, CMS guidelines, and payer-specific billing requirements.
- Monitor and analyze order and claim data received from our client.
- Support integration of billing systems.
- Assist in audit and reconciliation processes by providing system data and documentation.
Reporting & Data Analysis
- Develop and maintain dashboards and reports using tools like SQL or Power BI.
- Perform data analysis to support decision-making and identify trends in billing performance.
- Ensure data integrity and consistency across systems.
Project & Change Management
- Contribute to project planning, timelines, and resource allocation.
- Support change management initiatives including training and documentation.
- Track and report on project progress, risks, and issues.
- ServiceNow event logging and verification of change control compliance
Qualifications:
Required:
- Bachelor’s degree in Business, Information Systems, Healthcare Administration, or related field.
- 3+ years of experience as a Business Analyst, preferably in healthcare or billing systems.
- Strong understanding of healthcare billing processes, coding standards (ICD-10, CPT, HCPCS), and payer requirements.
- Proficiency in SQL and data visualization/reporting tools.
- Excellent communication, analytical, and problem-solving skills.
Preferred:
- Familiarity with HL7 and JSON data structures.
- Familiarity with HIPAA and CMS compliance standards.
- Agile/Scrum experience.
Working Conditions:
Hybrid (2 days onsite per week)