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Healthcare Business Rules Analyst

Acadian Ambulance Services

The candidate is responsible for handling mid-level support of custom developed accounts receivable software, independent research, and rule authoring. Rule authoring is a form of software development that includes complex computational analysis of system events, conditions, actions, sequencing, branch analysis, and chaining/recursion. Our current rules engine has hundreds of thousands of rules and millions of condition checks that require precise grouping and sequencing to ensure continuity of automated revenue cycle processes. Managing a robust and complex business rule set, as part of a team, includes functions similar to that of software development: debugging, troubleshooting, research, and new rule development.


Job Tasks

  • Complete rule adjustments for allowables and charges
  • Assist in troubleshooting application issues
  • Create effective systems documentation
  • Develop knowledge of the business and workflows
  • Analyze logical conditional pathways to confirm expected results
  • Determine business impacts on workflow and assist in the development of new workflows
  • Interpret business requirements into technical specifications
  • Develop on-going strategies for productivity improvements
  • Analyze rules for logical completeness, correctness, and optimization
  • Coordinate and prioritize multiple projects and deadlines
  • Conduct independent research with technical staff and subject matter experts
  • Recommend changes in testing methods as needed
  • Communicate complex information simply
  • Complete other assigned responsibilities
  • Other Continuity of Operations Duties as assigned
Qualifications
  • Minimum of 3 years of experience in healthcare software systems
  • Bachelor's degree in Health Information Management, Computer Science, MIS, Informatics preferred
  • 1 year of claims processing and reimbursement policy experience or equivalent knowledge preferred
  • Proficiency with Microsoft Office
  • Proficiency querying Microsoft SQL Server or other relational database is a plus
  • Knowledge of structured programming techniques and database methodologies is a plus
Vacancy posted 3 days ago
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