Principal, Business Operations
Kraken Digital Asset Exchange
Senior Business Operations Analyst
BASF
full-time
Posted on:
Location: 🇺🇸 United States
Visit company websiteSalary
💰 $80,000 - $95,000 per year
Job Level
Senior
Tech Stack
ETLSQL
About the role
- Analyze claims data leveraging COB/TPL/MSP expertise to identify trends and improve processes
- Conduct detailed data analysis, research, and present findings to support business decisions
- Assist technical and business leads with requirements gathering and documentation for implementations and program changes
- Create complex custom queries and perform QA/UAT as needed
- Collaborate with technical and business leaders to minimize risks and increase performance
- Review medical claims pre- and post-adjudication to identify business improvements
- Ensure compliance with client requirements, HIPAA, and applicable federal/state regulations; complete required training and clearances
Requirements
- Knowledge of healthcare claims, medical terminology, eligibility validation, COB/TPL, and MSP
- 7+ years relevant experience working with healthcare claims data
- Bachelor’s degree or equivalent combination of education and experience
- Experience with Medicaid, Medicare, and other TPL business models and products
- Experience with data modeling and analysis; requirements gathering, ETL processing, and data matching
- Proficiency in SQL; advanced skills in Excel and Access; ability to create complex custom queries
- Knowledge of X12 EDI Transactions (270/271, 277, 837, 835)
- Ability to work with large volumes of eligibility and claims data; QA and UAT experience
- Strong verbal and written communication, presentation, problem-solving, and independent work skills
- Ability to obtain and maintain client-required clearances and pass background/drug screening; HIPAA compliance
