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Verify transaction accuracy and ensure proper system processing.
Identify processing or system issues and provide documented feedback.
Execute escalation procedures when necessary.
Analyze regulations, controls, and operational requirements to support compliance.
Recommend process improvements and workflow enhancements.
Support operational and business projects while maintaining required documentation.
Serve as a subject matter expert (SME) when appropriate.
Evaluate new or modified processes to verify intended functionality.
Develop and maintain user guides, work instructions, and operational documentation.
Compile, analyze, and interpret data for reporting and operational decision-making.
Communicate findings, recommendations, and updates to internal and external stakeholders.
Participate in ongoing training and system education programs.
Experience3-5 years of experience within FEP Operations or a related healthcare claims environment.
Hands-on experience processing and adjusting FEP claims.
Experience with claims inventory management and transaction processing.
Strong understanding of the claim lifecycle and patient access-to-care concepts.
Experience with claims quality review, auditing, or operational compliance preferred.
Preferred Knowledge & Systems Medical, dental, and vision insurance are available to qualified candidates who meet eligibility requirements.
TC
The Copley Consulting Group
FEP Claims Business Analyst
Career Insights for Business Analyst (General)
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Based on Pennsylvania data
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What they do
A Business Analyst provides strategic management consulting to companies and businesses. Advises on ways to improve operations, increase efficiency, reduce costs and increase revenues; may recommend systems or organizational change. May specialize in an area of business practice or a specific industry; may also specialize in consulting with government agencies.
$96,282 / year median in Pennsylvania
-8% projected decline
Job Description
Title:
FEP Claims Business AnalystDuration:
3 months contract +Possibility of ExtensionLocation:
Philadelphia, PA 19103 - Hybrid Preferred /Remote ConsideredShift:
M-F 8 AM - 4
30PM Key Responsibilities:
Process, review, and adjust FEP claims accurately and timely.Verify transaction accuracy and ensure proper system processing.
Identify processing or system issues and provide documented feedback.
Execute escalation procedures when necessary.
Analyze regulations, controls, and operational requirements to support compliance.
Recommend process improvements and workflow enhancements.
Support operational and business projects while maintaining required documentation.
Serve as a subject matter expert (SME) when appropriate.
Evaluate new or modified processes to verify intended functionality.
Develop and maintain user guides, work instructions, and operational documentation.
Compile, analyze, and interpret data for reporting and operational decision-making.
Communicate findings, recommendations, and updates to internal and external stakeholders.
Participate in ongoing training and system education programs.
Required Qualifications:
Education:
Bachelor's Degree or equivalent combination of education and relevant work experience.Experience3-5 years of experience within FEP Operations or a related healthcare claims environment.
Hands-on experience processing and adjusting FEP claims.
Experience with claims inventory management and transaction processing.
Strong understanding of the claim lifecycle and patient access-to-care concepts.
Experience with claims quality review, auditing, or operational compliance preferred.
Preferred Knowledge & Systems Medical, dental, and vision insurance are available to qualified candidates who meet eligibility requirements.