Claims Analyst

Business AnalystThe Business Analyst is responsible for enabling high quality business analytics solutions in an Agile or Kanban context that deliver valued business outcomes and informed decisions for Zelis' key stakeholders. The Business Analyst works as part of the Scrum team to facilitate clear and open communication between Business Owners, Development, Quality Assurance, and the Product Owner. This role provides a major contribution to enhancing Zelis' overall capacity to meet the information technology needs of an ever-changing healthcare market. One of the core skills of a Business Analyst is requirements management (i.e., user and enabler stories). Developing stories and accurately defining the business solution begins with eliciting, understanding, and analyzing and the needs of the business. A core competency of this role is critical thinking, disciplined thinking that is clear, rational, open-minded, and informed by evidence. This person will act as liaison among Business Owners and/or Solutions Owners (i.e., Product Owner) to gather, analyze, document, communicate and validate business and system requirements and business methodologies. They will create and maintain Kanban or Agile artifacts which could include but are not limited to • Workflows/diagrams• User Stories • Enabler Stories • Release Notes • User Guides. Business Analysts will always look for ways to improve the current state ("AS-IS") by recommending a more efficient future state ("TO-BE")What you'll do:Participate in relevant ceremonies: Daily Stand-Ups, Backlog Grooming, Sprint Planning, Sprint Review, Sprint Retrospective.Leverage AI through all aspects of the role to facilitate user stories and requirements, acceptance criteria or any other aspect of their roleAssist with the elaboration of the user stories and requirements, supporting team members with their work where requiredBe responsible for providing multi-disciplinary teams with user stories and coaching to define the business-driven acceptance criteria and test cases. Proactively support the uplift of Agile or Kanban practices and foster a culture of continual service improvementConsult with the business and product owners to prioritize and shape the product backlog, using Agile or Kanban practices for prioritization around business valueDefine, implement, and maintain business processes and procedures to meet business objectives. Analyze and identify opportunities for business process improvements.Collaborate with Solution Owners and/or Product Managers when defining product release content and timeline, applying product development principles, innovative thinking and a focus around the customer or user experienceCritically evaluate information gathered from multiple sources, reconcile conflicts, and decompose high-level information into details.Create and maintain workflows, approval processes, and validation rules based on internal stakeholder requirements.Create training materials and documentation for internal and/or external applications.Perform a thorough gap analysis of existing to potential functionality for internal and/or external applications.Create Release Notes as determined by Product Owner.Perform analysis and identify gaps in functionality for system integrations.Collaborate with the Scrum team to establish the technical vision and analyze tradeoffs between usability and performance needs.Improves systems by studying current practices, designing modifications.Assist in Quality Assurance (QA) and/or User Acceptance Testing (UAT) of new software or enhancements to existing software as needed.The ability to multi-task and work on multiple assignments will be required.What you'll bring to Zelis:Bachelor's Degree4+ years of experience with Business Analysis and/or Business Process EngineeringDisciplined, structured and logical approach to problem solvingExperience in Healthcare industry preferredKnowledge of Payment Integrity solutions (hospital billing, claims editing, reimbursement methodologies and acceptable billing practices) preferredKnowledge of payer reimbursement policies, state and federal regulations and applicable industry standards preferredSQL experience preferredAbility to learn a new business and translate these needs into new products, and perform high-level troubleshooting functionalitySolid troubleshooting, analytical, and business process development skillsClear and concise communication both verbally and in writing.Preferred - SAFe POPM, Agilist, Teams, or Leading Safe certificationPlease note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future.Location and Workplace FlexibilityZelis is headquartered in the U.S., with multiple locations across the country and in Hyderabad, India. Check out our locations to learn more about our offices. All employee work locations are based on the needs of the position and are determined by the Leadership team. In-office work and activities vary based on work and team objectives in accordance with Company policies.While location expectations vary by role, candidates within approximately 50 miles of a U.S. office are generally preferred to support collaboration when needed. Our hybrid approach is flexible, and in-office presence is guided by team and business needs rather than a fixed weekly schedule.Base Salary Range$71,000.00 - $90,250.00At Zelis we are committed to providing fair and equitable compensation packages. The base salary range allows us to make an offer that considers multiple individualized factors, including experience, education, qualifications, as well as job-related and industry-related knowledge and skills, etc. Base pay is just one part of our Total Rewards package, which may also include discretionary bonus plans, commissions, or other incentives depending on the role.Zelis' full-time associates are eligible for a highly competitive benefits package as well, which demonstrates our commitment to our employees' health, well-being, and financial protection. The US-based benefits include a 401k plan with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits including medical, dental, vision, and prescription drug coverage.Equal Employment OpportunityZelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. We welcome applicants from all backgrounds and encourage you to apply even if you don't meet 100% of the qualifications for the role. We believe in the value of diverse perspectives and experiences and are committed to building an inclusive workplace for all.Accessibility SupportWe are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email View email address on click.appcast.io above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities, duties, and skills from time to time.