job summary: A Business Analyst specializing in Medical Claim Writing. The ideal candidate would be someone who knows the intricate details of a claim. They can identify and document the data points required to create a valid claim, such as patient or policyholder information, service codes (e.g., CPT codes in healthcare), dates of service, costs, and provider details. They understand how these data points are used and what happens to a claim at each stage of the process, from submission to final adjudication. This role involves understanding business needs, defining requirements, and collaborating with stakeholders to implement solutions that enhance efficiency and effectiveness in claims handling. location: Blue Bell, Pennsylvania job type: Contract salary: $50 - 55 per hour work hours: 8am to 5pm education: Bachelors responsibilities: Direct experience with major EHR systems (e.g., Epic, Cerner) and specialized claims management software (e.g., TriZetto, Facets) is highly valued. The BA needs to understand how data flows from the EHR to the claims system. The BA must have a strong working knowledge of medical billing and the ability to interpret and apply the correct codes for diagnoses, procedures, and services A solid understanding of medical terms, anatomy, and physiology is essential to accurately interpret medical records, physician notes, and patient data. The ability to analyze claims data to identify root causes of payment delays or denials is key. This includes using tools like Microsoft Excel, Power BI, or Tableau to create reports and dashboards that help business leaders make informed decisions. A deep understanding of the Health Insurance Portability and Accountability Act (HIPAA). This includes knowledge of privacy, security, and the standard transaction sets for electronic claims The BA must be able to research and interpret the billing and reimbursement policies of various government and commercial payers (e.g., Medicare, Medicaid, and private insurance companies). They need to understand how these policies impact the "claim writing" and adjudication process. qualifications: - Bachelor's Degree in a relevant discipline preferred (statistics, finance, management information systems, computer information systems, etc.); or 4+ years of relevant work experience. - Must have healthcare background / experience - Strong background in managing small to medium sized projects independently. - Must be highly analytical, well-organized and possess strong attention to detail. - Excellent verbal and written communication skill skills: - Assists with the definition of data requirements for specific dashboard projects and partner with internal teams as needed to obtain support for those requirements, removing blockers/risks - Provides additional analysis or insight to add value to the metrics. - Identifies and recommends ongoing continuous improvement opportunities to maximize team/process efficiencies. - Collaborates effectively with other job functions within team, to ensure end-to-end coordination/efficiency with scheduled releases Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.At Randstad Digital, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com. Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad Digital offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility). This posting is open for thirty (30) days. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.