Wipro
Business Analyst - Client Facing (Healthcare)
Join to apply for the
Business Analyst - Client Facing (Healthcare)
role at
Wipro The Business Analyst (BA) of Claims is responsible for forming, building and maintaining connections with the Client to help drive results for the third-party administration (TPA) of Claims Operations. In this role, the BA of Claims will provide client advice, build rapport, run reports on performance data and production and provide timely responses to their inquiries as it relates to various aspects of claims processing. The BA will interface and report into our Tampa Claims Operations. This role is required to work in the office, 5 days a week for the first 3 months of employment. Depending on performance, the role would then be eligible for Hybrid work, in office for 3 days a week. Responsibilities
Build and improve relationships with customers, key suppliers and partners. Coordinate the review and response of Provider and member escalations; meeting all Department of Labor and customers requested guidelines for accuracy, timeliness and documentation. Work with other responsible teams to assist in the research and response to complaints. Teams may be internal or external. Work with internal departments to ensure the company meets the customers expectations. Respond to customer emails promptly and follow up on response and escalation matters as needed. Address customer complaints and resolve issues efficiently. Identify and close early warnings (risks) on projects to avoid any customer escalations. Creates formal networks with key internal and external decision makers. Process and adjudicate claims and claims adjustments. Provide GetNext oversight and direction to stay on top of HICS L1, HICS L2, and DOI pendings and clearing of aged items. Communicate changes, enhancements, and modifications of business requirements to the customer, project managers, and other stakeholders so that issues and solutions are understood. Follow all HIPAA guidelines for the release of information. Work directly with the Offshore team regarding NERD feedback and SOP updates. Generate daily activity reports and support Operational meeting reporting for the customer; provide month end reporting and any other required reporting needs. Plan and conduct Operational meetings, customer QBR or other sessions as required. Conduct regular customer connects and participate in Management Review Meetings to understand the customers needs and seek feedback to improve delivery methodology, timelines, and resource allocation. Liaise between the customer and internal delivery teams to understand operational requirements, goals, and drive project health by adhering to project metrics. Achieve quality and member satisfaction goals; develop an operational roadmap to drive continuous improvement in customer satisfaction and efficiencies. Lead project planning and process updates; evaluate alternative solutions and develop strategies to maximize customer success. Apply analytical techniques to research issues, synthesize results, evaluate data quality, and identify key process variables; use findings to drive decisions and recommendations. Design and monitor project performance dashboards/reports for the customer. Serve as a backup to complete production packages to ensure SLA/KPI are met. Ensure 100% compliance to project SLAs and information security protocols; monitor audit findings to prevent major non-compliance. Qualifications
Excellent conflict resolution and interpersonal skills and the ability to build lasting relationships with customers. Excellent organization and prioritization skills with strong attention to detail. Excellent facilitation, follow-up and documentation skills. Exceptional analytical and conceptual thinking; proficiency in eliciting, analyzing, and documenting business and technical requirements for stakeholders. Ability to lead and work within a team; strong problem-solving and decision-making abilities. Knowledge of Claims Processing and Benefit plan interpretation. Strong oral and written communication skills; strong numerical skills and ability to reconcile statements. 834 trained with processing knowledge; SME on processing procedures and able to assist with production queues as needed. Advanced skills in Microsoft Office suite (Outlook, Excel, Word, PowerPoint). Familiarity with the insurance industry; ability to understand regulatory and contractual requirements. Flexibility and resilience amid multiple demands and changes; maintain confidentiality. Ability to work independently; strong self-management. Interest in federal health policy and healthcare reform; experience translating regulations into business requirements is preferred. Education
5 years experience in the Healthcare environment. Bachelors degree in business or related field preferred. Expected annual pay for this role ranges from $45,000.00 to $110,000.00. Based on the position, the role is eligible for Wipros standard benefits, including medical and dental benefits, disability insurance, paid time off (including sick leave), and other paid and unpaid leave options. Reinvent your world. We are building a modern Wipro. We are an end-to-end digital transformation partner with the boldest ambitions. To realize them, we need people inspired by reinvention. Join a business powered by purpose and a place that empowers you to design your own reinvention. Come to Wipro. Realize your ambitions. Applications from people with disabilities are explicitly welcome. Seniority level
Mid-Senior level Employment type
Full-time Job function
Health Care Provider Industries
Hospitals and Health Care Referrals increase your chances of interviewing at Wipro by 2x Get notified about new Business Analyst jobs in Helena, MT. #J-18808-Ljbffr
Join to apply for the
Business Analyst - Client Facing (Healthcare)
role at
Wipro The Business Analyst (BA) of Claims is responsible for forming, building and maintaining connections with the Client to help drive results for the third-party administration (TPA) of Claims Operations. In this role, the BA of Claims will provide client advice, build rapport, run reports on performance data and production and provide timely responses to their inquiries as it relates to various aspects of claims processing. The BA will interface and report into our Tampa Claims Operations. This role is required to work in the office, 5 days a week for the first 3 months of employment. Depending on performance, the role would then be eligible for Hybrid work, in office for 3 days a week. Responsibilities
Build and improve relationships with customers, key suppliers and partners. Coordinate the review and response of Provider and member escalations; meeting all Department of Labor and customers requested guidelines for accuracy, timeliness and documentation. Work with other responsible teams to assist in the research and response to complaints. Teams may be internal or external. Work with internal departments to ensure the company meets the customers expectations. Respond to customer emails promptly and follow up on response and escalation matters as needed. Address customer complaints and resolve issues efficiently. Identify and close early warnings (risks) on projects to avoid any customer escalations. Creates formal networks with key internal and external decision makers. Process and adjudicate claims and claims adjustments. Provide GetNext oversight and direction to stay on top of HICS L1, HICS L2, and DOI pendings and clearing of aged items. Communicate changes, enhancements, and modifications of business requirements to the customer, project managers, and other stakeholders so that issues and solutions are understood. Follow all HIPAA guidelines for the release of information. Work directly with the Offshore team regarding NERD feedback and SOP updates. Generate daily activity reports and support Operational meeting reporting for the customer; provide month end reporting and any other required reporting needs. Plan and conduct Operational meetings, customer QBR or other sessions as required. Conduct regular customer connects and participate in Management Review Meetings to understand the customers needs and seek feedback to improve delivery methodology, timelines, and resource allocation. Liaise between the customer and internal delivery teams to understand operational requirements, goals, and drive project health by adhering to project metrics. Achieve quality and member satisfaction goals; develop an operational roadmap to drive continuous improvement in customer satisfaction and efficiencies. Lead project planning and process updates; evaluate alternative solutions and develop strategies to maximize customer success. Apply analytical techniques to research issues, synthesize results, evaluate data quality, and identify key process variables; use findings to drive decisions and recommendations. Design and monitor project performance dashboards/reports for the customer. Serve as a backup to complete production packages to ensure SLA/KPI are met. Ensure 100% compliance to project SLAs and information security protocols; monitor audit findings to prevent major non-compliance. Qualifications
Excellent conflict resolution and interpersonal skills and the ability to build lasting relationships with customers. Excellent organization and prioritization skills with strong attention to detail. Excellent facilitation, follow-up and documentation skills. Exceptional analytical and conceptual thinking; proficiency in eliciting, analyzing, and documenting business and technical requirements for stakeholders. Ability to lead and work within a team; strong problem-solving and decision-making abilities. Knowledge of Claims Processing and Benefit plan interpretation. Strong oral and written communication skills; strong numerical skills and ability to reconcile statements. 834 trained with processing knowledge; SME on processing procedures and able to assist with production queues as needed. Advanced skills in Microsoft Office suite (Outlook, Excel, Word, PowerPoint). Familiarity with the insurance industry; ability to understand regulatory and contractual requirements. Flexibility and resilience amid multiple demands and changes; maintain confidentiality. Ability to work independently; strong self-management. Interest in federal health policy and healthcare reform; experience translating regulations into business requirements is preferred. Education
5 years experience in the Healthcare environment. Bachelors degree in business or related field preferred. Expected annual pay for this role ranges from $45,000.00 to $110,000.00. Based on the position, the role is eligible for Wipros standard benefits, including medical and dental benefits, disability insurance, paid time off (including sick leave), and other paid and unpaid leave options. Reinvent your world. We are building a modern Wipro. We are an end-to-end digital transformation partner with the boldest ambitions. To realize them, we need people inspired by reinvention. Join a business powered by purpose and a place that empowers you to design your own reinvention. Come to Wipro. Realize your ambitions. Applications from people with disabilities are explicitly welcome. Seniority level
Mid-Senior level Employment type
Full-time Job function
Health Care Provider Industries
Hospitals and Health Care Referrals increase your chances of interviewing at Wipro by 2x Get notified about new Business Analyst jobs in Helena, MT. #J-18808-Ljbffr