Business Analyst (Revenue Cycle Management)

About the role

We are seeking an experienced Business Analyst with strong expertise in medical billing , healthcare operations , and financial reconciliation to support implementations for specialty and infusion pharmacies. The Business Analyst is the liaison between the design and development teams and the client to define the objectives and requirements of the client. Finalizes the implementation process by implementing development plans. The ideal candidate has deep familiarity with revenue cycle processes and has collaborated closely with finance teams. Duties and Responsibilities: Serve as the subject matter expert for medical billing and financial reconciliation Work with client to understand their Revenue Cycle Management requirements of the system. Work with Product development to communicate the client's needs and provide business case for enhancement requests. Accountable for RCM functional track, deliverables, and assist QA and Support with understanding Client needs. Creating and maintaining deliverables within assigned area. Participate in testing the product before it is released to the client. Assist in triaging escalated system defects and/or providing clarification on defects and works to resolve them. Integrated throughout the full client lifecycle, including RFP development, product demos, project kick-off, implementation, go-live, and ongoing optimizations. Collaborate with the RCM Product Manager on Product/Knowledge Share. Provide support to the team during implementation as well as post go live. Provide support to RCM SME's for client training initiatives. Document and maintain deliverables (requirements document, Configuration Design Doc, etc.). Document process workflow. Build and configure system based on design. Ensuring configuration meets requirements and works as expected. Maintain industry expertise. Provide support for internal training events as necessary. Rely on experience and judgment to plan and accomplish goals. A wide degree of creativity and latitude is expected. Maintain compliance with lnovalon's policies, procedures and mission statement. Adhere to all confidentiality and HIPAA requirements as outlined within lnovalon's Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position. Fulfill those responsibilities and/or duties that may be reasonably provided by lnovalon for the purpose of achieving operational and financial success of the Company. Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function. We reserve the right to change this job description from time to time as business needs dictate and will provide notice of such. Technology On-Call Policy None. Education: Bachelor's Degree in Arts/Sciences (B.A./B.S.) in Healthcare and IT or related field or a combination of education and experience required

Requirements

• 2+ Years of experience with medical billing and financial reconciliation
• 2+ Years of experience as a software business analyst required
• 1-2 Years of experience in a healthcare/specialty pharmacy related environment required
• Skills and Abilities:
• Strong background in healthcare/specialty pharmacy revenue cycle processes
• Must be familiar with healthcare/pharmacy system designs and concepts
• Possesses excellent communication, organizational and observational skills
• Proficient problem-solving skills with good judgment and decision making
• Must be goal-oriented and focused
• Work well as a member of a team
• Possess SQL and Crystal Reports skills
• Working Conditions and Physical Demands:
• This is a primarily sedentary role. The employee is regularly required to sit, talk, and hear for extended periods of time, and also required to repetitively use manual labor to operate a computer keyboard and other office equipment.
• The employee may occasionally need to stand, walk, or lift

Benefits

Additional Information

Inovalon was founded in 1998 on the belief that technology, and data specifically, would empower the transformation of the entire healthcare ecosystem for the better, improving both outcomes and economics. At Inovalon, we believe that when our customers are successful in their missions, healthcare improves. Therefore, we focus on empowering them with data-driven solutions. And the momentum is building. Together, as ONE Inovalon, we are a united force delivering solutions that address healthcare's greatest needs. Through our mission-based culture of inclusion and innovation, our organization brings value not just to our customers, but to the millions of patients and members they serve. Location: This position is a hybrid role based out of our Canonsburg, PA office. The current expectation is that we are in office two days each week (Tuesday-Wed), with extra additional days as required during the month. Business Unit: Pharmacy (software Scriptmed) Travel: up to 20% to clients sites

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