Claims Business Analyst

About this role

We exist for workers and their employers -- who are the backbone of our economy. That is where Centivo comes in -- our mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills.


Summary of role:
As a Claims Business Analyst, you will be responsible for triaging operational issues and leading projects and tasks to completion. You will use your claims adjudication experience and TPA background to triage operational concerns, vendor issues, and related claims issues. Familiarity with Centivo’s claims systems (Javelina and HealthRules Payer) is preferred. You will coordinate with all business units and external vendors during client implementations and conversions to determine requirements. This role ensures seamless integration between internal and vendor systems to support client requirements and operational workflows. Additionally, you will lead key projects and tasks identified to improve efficiency of Centivo’s Claim team. This role will use data analytics and other tools to identify areas of improvement needed in the business, scope out the initiative, and then lead the project through to completion.


Responsibilities Include:

• Support the Centivo Claims Team with troubleshooting issues, identifying the root cause and magnitude, and then researching and recommending the best solution.
• Effectively work with end-users and operational partners to identify business needs and to ensure implementations meet business requirements and appropriately address prioritized needs.
• Develop and maintain advanced reporting, dashboards, KPI’s and business insights to support operational decision-making through measurement of performance and effectiveness of processes.
• Assist with creating Process Flows on new initiatives and existing processes as needed.
• Function as a liaison between business and technical resources to ensure people, processes, and solutions meet or exceed the needs of our Clients...