BASF

Senior Business Operations Analyst

BASF

full-time

Posted on:

Origin:  • 🇺🇸 United States

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Salary

💰 $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