Performant Corporation is an Equal Opportunity Employer (Minorities/Females/Disabled/Veterans).

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Sr. Business Analyst/Quality Analyst (Eligibility)
Job Code:2022-50-R-078
Location:United States - Remote
Status:Regular Full Time
  
Responsibilities:
We are seeking a Sr. Business Analyst/Quality Analyst with strong knowledge of healthcare eligibility, healthcare claims, medical terminology, eligibility validation practices, Coordination of Benefits and Third-Party Liability (COB/TPL), or Medicare Secondary Payer (MSP).  This position requires a detail-oriented quality assurance tester, documenter, and team player to capture user-stories and business requirements. This position will actively support new client implementations and existing programs. 


Essential Duties
•Lead various business requirement discussions and act as a liaison between the business and IT/ Developers
•Create and design documentation including current and future business processes flow diagrams, functional and non-functional requirements, use cases, business rules and other information or processes as required 
•Develop SQL queries, analyze and test results to ensure positive outcomes
•Analyze business-specific questions and communicate them to developers in easy-to-understand written format 
•Translate developer requests and communicate with business
•Coordination QA and UAT
•Conducts a variety of data analysis for intelligent insights using subject matter knowledge, independent judgement, and analytical expertise
•Develops custom queries and reporting, conducts research, analyzes trends and activities, and presents data and findings based upon business needs and as need to identify opportunities, root causes of issues and to support business decisions and strategies
•Follows and complies with company, departmental and client program policies, processes, and procedures
•Responsible for utilizing resources to ensure compliance with client requirements, HIPAA, as well as applicable federal or state regulations
•Successfully completes, retains, applies, and adheres to content in required training as assigned
•Completes required processes to obtain client required clearances as well as company regular background and/or drug screening; and successfully passes and/or obtains and maintains clearances statuses as a condition of employment. (note: client/government clearance requirements are not determined or decisioned by Performant.)
•Demonstrates Performant core values in performance of job duties and all interactions.
•Correct areas of deficiency and oversight received from quality reviews and/or management
•Operates under minimal supervisor to deliver results aligned with business goals, given guidance in the form of high-level objectives
•Telework in adherence with Company policies and requirements. 
•Other duties and assignments as required to meet business needs




*Note - All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times.  Violations to Performant’s policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.
 
Required Skills and Knowledge:
•Knowledge of and ability to work with large volumes of health care eligibility and claims data
•Familiar with JIRA Project use and reporting 
•Proficient SQL skills to query and test 
•Experience with Medicaid / Medicare / Other TPL business models and products
•General knowledge of requirements gathering, ETL processing and data matching
•Strong system skills with ability to quickly develop expertise in new systems and applications
•Advanced skills in Excel, Access and/or other data analysis applications
•Advanced knowledge of X12 EDI Transactions, including, but not limited to 270/271, 834, 277, 837, 835 
•Professional verbal and written communication with good presentation skills
•Able to work independently and meet deadlines with minimal supervision
•Strong problem solving and communication (written and oral) skills
•Ability to produce results and maintain positive attitude in fast paced, dynamic environment
•Self-motivated and thrives in a fast-paced business operations department performing multiple tasks cohesively, with keen attention to detail
•Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety & ergonomics, confidentiality, and dedicated work focus without distractions during work hours.
 
Physical Requirements:
**NOTE: Must be able to meet requirements for and perform work assignments in accordance with Company policies and expectations on a home remote basis (and must meet Performant remote-worker requirements). Basic office equipment required to perform remote work is provided by the company.
•Job is performed in home-office setting (subject to Company approval and Teleworker Agreement), performs work at a desk or appropriate work surface, uses system and headset provided by the Company for calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a mouse.
•Reads and comprehends information in electronic (computer) or paper form (written/printed). 
•Sit/stand 8 or more hours per day; has the option to stand as needed while on calls; reach as needed to use office equipment.
•Consistently viewing a computer screen and types frequently, but not constantly, using a keyboard to update accounts.
•Consistently communicates on the phone as required primarily within the department and company and may include client contacts or other third-party depending on assignment with account holders, may dial manually when need or use dialer system; headset is also provided.
•Occasionally lift/carry/push/pull up to 10lbs.

Education and Experience:
•Bachelor’s degree in relevant field or equivalent combination of education and experience.
•5+ years relevant experience working with healthcare eligibility or client data 
•Experience with data modeling and analysis
•Knowledge and experience with Healthcare, Coordination of Benefits, Third Party Liability, and/or •Medicare Secondary Payer


Other Requirements and Notices
•Must submit to and pass pre-hire background check, as well as additional checks throughout employment
•Must be able to pass a criminal background check; must not have any felony convictions or specific misdemeanors, nor on state/federal debarment or exclusion lists.
•Must submit to and pass drug screen pre-employment (and throughout employment).
•Performant is a government contractor. Certain client assignments for this position requires submission to and successful outcome of additional background and/or clearances throughout employment with the Company.
  
Visa sponsorship is not available.


Job Profile is subject to change at any time.



EEO 
Performant Financial Corporation is an Equal Opportunity Employer. 
Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. 




NO AGENCY SUBMISSIONS (unless approved Performant agency partner with authorized job order for this specific job requisition)