Thryve Digital - Business Analyst - Claims & FEP
- Thryve Digital
- 6 - 9 years
- Hyderabad
- 12 days ago
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Job Description
Thryve Digital Health LLP is looking for a Business Analyst with Claims along with FEP(Mandatory) experience. If your profile suits for the below opportunity. Share your interest by applying Or you can InMail to ru****************n@th**********l.com
Role Summary:
This job provides expertise for standard to moderately complex problem solving and in-depth understanding of system functionality. The incumbent reviews significant amounts of information and analyzes processes to support business unit needs. May troubleshoot errors, conduct impact analyses, and/or solve data rejection. Performs business analyses in one or more operational areas. Identifies process gaps and recommends process improvements for efficiencies. May provide guidance to Associate level employees.
Job Role : Business Analyst - Claims Adjudication with FEP
Experience - 6-9 Years
Work Location - Chennai/Hyderabad
Work Mode - Hybrid
Shift - 3PM - 12AM
Essential Responsibilities
Analyze Claims Tickets :
- Research/analyzes provider/Claims issue at hand
- Determines if provider/claim specific or global issue
- Actions taken could be ticket submissions to HMHS, pricing updates, provider file updates, collaboration with various internal stakeholders or Provider Relations, communications sent to Operations on global issues
- Requests cleanup report once issue is corrected, if required
- Follows cleanup through completion and notifies Provider Relations
- Facilitate process improvement meetings and/or discussions.
- Analyze the functions and operations of a business area/function and identify problem areas. Create process mapping and document current and future state business processes.
- Recommend process efficiencies, strategies for improvement, and/or solutions to align technology with business strategies
- Assist in the development of desktop procedures and/or training material.
- Coordinate, monitor, and report on the progress of clean-up projects to ensure adherence to defined project schedule
- Communicate effectively with customers and colleagues. Successfully articulate issues, problems, and solutions.
The experience we are looking to add to our team require:
- 6-9 years experience in Claims and Adjustments in Federal Employee Program (FEP) business
- Business Analyst with minimum 2 years of experience in FEP.
- Claims and Adjustment subject matter expertise
- Can adjudicate and adjust the claims
- BlueCard Home and Host knowledge
- Strong claims research skills are a must
- High level of systems and business knowledge
- Knowledge of INSINQ, Oscar, OCWA, CPBRE (Oscar Benefits), FEP Direct
- Business Process Improvement
- Collaborative Problem Solving
- Excellent analytical and problem-solving skills
- Bachelors or masters degree in any discipline
- Good verbal and written skills
- Good analytical and interpersonal skills
- Exceptional people management
Good to have:
- AHM or any equivalent certification
- Additional quality/operational certifications
- Business acumen on Adjustments and Offset/Recovery
Job Classification
Industry: IT Services & ConsultingFunctional Area / Department: Data Science & AnalyticsRole Category: Business Intelligence & AnalyticsRole: Business AnalystEmployement Type: Full timeContact Details:
Company: Thryve DigitalLocation(s): Hyderabad
Keyskills: fep Business analyst brd Requirement Gathering claims frd uat business analysis federal employee programme claim claims adjudication
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