Sr Quality Business Analyst
The FEP Sr. Quality Business Analyst supports FEP Claims Operations with ensuring the quality of the transaction work performed by FEP Claims Operations and the processing vendor. The FEP Sr. Quality Business Analyst also participates in the various FEP Claims Operations transaction workstreams.
- Review FEP transactions to ensure accuracy of transaction and
- system processing. Provide timely documented feedback on
- issues identified at the processor and/or system level and
- execute escalation procedures if applicable
- Maintain flexibility in a team environment and identify process improvement opportunities and define system impacts that may result.
- Ability/willingness to participate in departmental knowledge transfer activities to facilitate cross-training efforts.
- Actively represents the FEP Claims Team on various projects and possesses proven ability to identify required action items and impacts.
- Represent FEP Claims Team on assigned projects, providing feedback and assessing impacts accordingly
- Identify FEP process improvements and develop workflow and/or system recommendations
- Support lead analyst or supervisor in all project related activities (analysis, tracking, etc.)
- Develop and maintain FEP user documentation ensuring the most current information is available to the production areas.
- Communicate effectively in writing and verbally with in work groups and internal and external customers
- Attend internal and external education training to achieve and maintain proficiency on all systems
- Support assigned projects, maintain appropriate documentation at a task level, monitor deadlines and budget allocations and service as a technical liaison when appropriate
- Assist with designing test plans and evaluate/ test new or modified processes and procedures to verify that the new programs or program changes are functioning as intended and conform to established policies. Maintain detailed testing notes, cases and outcomes to support all findings
- Familiarity with FEP process flows, regulatory impacts and timelines to ensure requirements, testing and implementation are in compliance across operational disciplines.
- Proven experience to assess FEP regulations and required controls and incorporating what is required into the specifications and/or documentation
- Proven ability to compile FEP detailed system requirements, reporting and data mining to support business needs that meet the need.
- Proficient in FEP trend analysis and communicating as the liaison with business partners on findings and recommendations focused on minimizing impacts to other areas and the customer.
- Superior written and verbal communication skills are required to provide business units with FEP information and tools to support system modifications and/or new installations.
Required:
- FEP Facility Claims Processing and adjustment experience
- FEP Facility Claims Quality and Audit experience
- Minimum of 5 to 8 years work related experience
- BS/BA Undergraduate degree or equivalent related experience
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Inclusion and Belonging
At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
About Our Company
Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.
At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!
Equal Employment Opportunity
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an Independence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.
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