Claims Business Analyst

A client of Innova Solutions is immediately hiring a Claims Business Analyst.

Position type: Full Time - Contract role
Duration: 3+ Months
Location: Philadelphi, PA

As a Claims Business Analyst, you will:

• Be supporting the processing team with analysis of claim issues and inquiries. Perform root cause analysis and course correct identified issues for full resolution.
• Be working with other plans to resolve issues for members
• Be researching root cause of incorrectly processed claims, failed DF and RFs. Providing solutions and coordinating with appropriate team members to repair the claim and provide re-education to the processor or submitting tickets for system enhancement.
• Be focusing on applying technologies to continuously increase claims process improvements with the use of data, Bots and applications/tools.
• Be sharing this knowledge and skill with other team members to instill across the team the opportunities that they can escalate to process improve. Scheduling reoccurring meetings to keep momentum.
• Be responsible for evaluating current business processes and developing, implementing, testing and maintaining Technology for more cost effective or quality improvement processing.
• Be assisting with pulling needed data and assist with the documentation of processes and work procedures.
• Be representing Department as SME in meetings, projects and company initiatives.

The ideal candidate will have:

• 3 years or more of experience in medical claims processing and adjusting or healthcare administration.
• Expertise in the Blue Squared application.
• Working experience with SQL and Access.
• Advanced skills in Microsoft Office and with Microsoft platforms (e.g. Excel, Word, PowerPoint)

Preferred Qualifications:

• Experience with Tableau.
• Knowledge of medical billing codes (ICD-10, CPT, HCPCS), claims processing software, and a strong understanding of the BlueCard product.

Qualified candidates should APPLY NOW for immediate consideration!
This position is only open to applicants who can be engaged on a W-2 basis.
Please hit APPLY to provide the required information, and we will be back in touch as soon as possible.
We are currently interviewing to fill this and other similar positions. If this role is not a fit for you, we do offer a referral bonus program for referrals that we successfully place with our clients, subject to program guidelines. ASK ME HOW.
Thank you!

Gangotri Chakraborty
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PAY RANGE AND BENEFITS:
Pay Range*: Between $48.00 - $52.00 per hour
*Pay range 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.

Benefits: Innova Solutions offers benefits( based on eligibility) that include the following: Medical & pharmacy coverage, Dental/vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP).

ABOUT INNOVA SOLUTIONS: Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields.

Recent Recognitions:

• Named One of America's Best Employers for New Grads by Forbes (2024
• Named One of the Best Companies to Work for by U.S. News & World Report (Private Companies List, 2024-2025)
• One of the Largest IT Staffing Firms in the US - Ranked #3 by Staffing Industry Analysts (SIA, 2024)
• One of the Largest Staffing Firms in the US - Ranked #13 by Staffing Industry Analysts (SIA, 2024; includes Innova Solutions, Volt, & HireGenics)
• Named One of the Top Ten Private Companies in Atlanta by the Atlanta Business Chronicle (2023)
• One of the Largest Certified Minority Business Enterprises (MBEs) in the United States (NMSDC, 2024)
• AWS Advanced Tier Services Partner with 100+ certifications

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Innova Solutions offers a referral bonus for qualified Ambassadors who refer eligible referrals. Submit referrals at and earn $250-$1,000 per referral.
Innova Solutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment, please contact us at View email address on click.appcast.io or View phone number on click.appcast.io. Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities. Innova Solutions (HireGenics/Volt) does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. § 1324b.
The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.
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