Business Analyst III Encounters Claims, EDI, SQL

Position Purpose: Perform various analysis and interpretation to link business needs and objectives for assigned function.

Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

Strong SQL writing and query development skills, including experience creating, optimizing, and maintaining database tables to support business reporting, data analysis, and operational decision-making strongly preferred.

Experience with healthcare encounters and EDI transactions, including data analysis, troubleshooting, reconciliation, and support of end-to-end business processes strongly preferred.

• Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems

• Identify and analyze user requirements, procedures, and problems to improve existing processes

• Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations

• Identify ways to enhance performance management and operational reports related to new business implementation processes

• Coordinate with various business units and departments in the development and delivery of training programs

• Develop, share, and incorporate organizational best practices into business applications

• Diagnose problems and identify opportunities for process redesign and improvement

• Formulate and update departmental policies and procedures

• Serve as the subject matter expert on the assigned function product to ensure operational performance

• Complies with all policies and standards

Education/Experience: Bachelor’s degree in related field or equivalent experience. 4+ years of business process analysis (i.e. documenting business process, gathering requirements) experience in healthcare industry or 3+ years of managed care encounters experience. Experience with encounters or claims business analysis experience in healthcare, preferably managed care or Medicaid. Knowledge of Amisys or other claims system, HIPAA transactions (i.e. 837, 999, 824, 277) and SQL scripting preferred.

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
 

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act