The Business System Analyst will become an expert in the software and advise the organization on preferred options for business and technical configuration. In this role, you'll be responsible for application configuration and leverage your project planning, execution, and implementation acumen to drive changes to our business applications. You will help trouble-shooting system issues, attend design meetings, work to understand business requirements and put them into actionable plans, understand custom configuration needs and work with technical resources to scope and develop required solutions. You will also be participating in 3rd Party application implementation project and updates.
This position is 100% remote.
• Implement and configure the QNXT health claims system by prototyping, analyzing, implementing and documenting the process changes
• Serve as resident QNXT Application Expert
• Creating custom SQL queries in SQL server databases
• Analyze application configuration to ensure it is efficient in setup and functionality
• Provide feedback into business requirement documents used to build custom solutions and interfaces
• Provide project management and oversight on ongoing QNXT related projects based on Manager's direction
• Evaluate solutions and configuration activities to ensure that the most efficient solutions are implemented
• Assist in the writing of department policy and procedure documents
• Develop and recommend operational processes improvements and ensure that technical configuration meets the organization's business needs
• Develop process maps as needed
• Develop 'helpful hints' or other job aides to assist team members
• Train new employees as needed
• Attend meetings for Manager at Manager's request or in their absence
• Provide data validation for conversion and interface data
• Partner with our testing team/ business areas to develop and execute appropriate test plans and ensure the configuration or customization changes work as was intended.
• Document functional specifications for system solutions and enhancements to existing business systems
• Trizetto/Cognizant QNXT working or configuration experience
• Expertise with SQL
• Strong analytical and critical thinking skills
• Ability to work independently in a hands-on role
• Strong facilitation skills
• In-depth understanding of System Design Methodologies
• Strong verbal and written communication skills
• Demonstrated ability to manage multiple timelines and priorities
• Proficient knowledge of flow charting/process mapping
• Understanding of the Insurance Marketplace, especially government programs
• Functional knowledge of healthcare claims processes and payment methodologies such as (MS-DRG, APR- DRG, APC, OPEAPG, ASC Groupings, Per Diem and Capitation)
• Functional understanding of health care claim data sets such as ICD-10, CPT, HCPCS, and Rev Codes
• Understanding of member benefit configuration such as Deductibles, Co-Pays, Co-Insurance, Benefit Maximums and Accumulators
• 3+ years of experience working in Information Systems or other related areas providing application support and/or configuration management
• 3+ years of working experience in health insurance industry
• 3+ years' experience writing TSQL or SQL queries
• Demonstrated experience around QNXT Systems Configuration, version 5.3 or later
• In-depth knowledge around Claims, Benefits, Service Group Design, Contracts, QNXT Rules, QNXT Edit Structure and Fee Tables required
• Experience with developing SQL queries and working with QNXT back-end tables
• Project management experience a plus
Business Analyst, System Analyst, Test Cases, Healthcare, QNXT
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.