Provider Outreach Business Analyst II
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Norfolk • Kentucky • Virginia • United States
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About the role
- Conduct outbound provider calls to confirm that services were rendered, and that the provider was expecting payment
- Review claim details to determine claim validity before initiating outreach, ensuring all required information is accurate and complete
- Meet or exceed daily outbound call attempt requirements as established by departmental performance metrics
- Maintain a QA (Quality Assurance) score of 95% or higher
- Provide excellent customer service when interacting with providers
- Document call outcomes and follow-up activities in required systems
- Review and evaluate payment integrity recovery requests from external partners
Requirements
- Requires a BA/BS
- minimum of 3 years related business analysis experience
- 2–4 years of experience in healthcare claims analysis, payment integrity, or related field strongly preferred
- Proficient in Facets, Macess, and Microsoft Office Suite (Excel, Word, Outlook) preferred
- Experience in medical claims processing workflows and systems preferred
- Familiarity with data analysis or query tools (e.g., SQL, Tableau, or similar) preferred
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
business analysishealthcare claims analysispayment integritydata analysisSQLTableaumedical claims processingMicrosoft Office SuiteExcelWord
Soft skills
customer servicecommunicationattention to detailorganizational skillsquality assurance
Certifications
BABS