Jobs in America

Business Analyst III(Medicare Claims)

Sunshine State Health Plan
Bachelor Degree 4 Year

Although this job is based in Miami, you can work remotely from any location. The job vacancy for the Business Analyst III(Medicare Claims) role was posted on December 10, 2023, and it will end on March 8, 2024. You have the chance to negotiate your salary with the employer based on the company's approach to employee job flexibility and remote work options. Interested in a full time job with Sunshine State Health Plan? Apply now. To qualify for this job, you must have at least 48 months of work experience in the same field.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Perform various analysis and interpretation to link business needs and objectives for assigned function.
  • 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.
  • Ability to travel
Education/Experience: Bachelor’s degree in related field or equivalent experience. 4-6 years of business process or data analysis experience, preferably in healthcare. Advanced knowledge of Microsoft Applications, including Excel and Access preferred. Project management experience preferred.

When looking for jobs online, it's crucial to remember some vital factors to ensure that you find legitimate job postings and avoid scams. Avoid job postings that require you to share your personal bank account information for any reason. Remember that protecting your personal information is crucial to avoid identity theft and other forms of fraud. Check the website's URL and ensure you are on the verified website to avoid any negative consequences. To verify that the job posting is real and the position is open, it's always a good idea to get in touch with the company directly. Be careful of job postings that claim to be for a -limited time only- or have an urgent deadline. To avoid working for a company that doesn't prioritize diversity and inclusion, research the organization's policies and initiatives before applying for any job. Legitimate employers will usually follow standard hiring practices, which include conducting interviews in person or over the phone. Legitimate employers will not ask you to pay for a criminal background check before being hired. If a job posting gives you a bad feeling, it's better to err on the side of caution and not apply.

Compliance Coding/Prepay Compliance (Payment Integrity): Bachelor’s degree in related field or equivalent experience. 4+ years of business process analysis (i.e. i.e. documenting business process, gathering requirements). Experience in healthcare industry, preferably with managed care techniques and administrative philosophy. Experience in claims coding analysis or medical claim review/research preferred. Knowledge of Amisys claims payment system and Business Objects preferred.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.

Use the job posting to evaluate if this job aligns with your work style and preferences. If you are excited about this job opportunity and believe that you can fulfill the expectations, we welcome you to apply. The quality of your job application is a reflection of your professionalism and commitment to excellence. Please make sure to carefully review the job requirements before submitting an application.