Business Analyst II

Role: Regulatory Compliance Analyst II

Role Summary

A results-driven Business Analyst responsible for supporting Service Delivery, Operations and Leadership by investigating questions regarding Workers Compensation and Automobile Fee Schedule Compliance. In this role, you will be responsible for identifying automation gaps and explaining fee schedule rule interpretation.

Key Responsibilities

Subject Matter Expert in Workers Compensation and Automobile Fee Schedule Rules and Regulations

Help to identify Workers Compensation and Automobile compliance gaps

Respond to SalesForce cases from Clients, Service Delivery and Operations regarding questions on pricing and rules for assigned states within SLA guidelines

Engage the state implementation Business Analysts when potential issues are identified

Track Case production in a weekly tracker that will need to be submitted to the manager weekly

Perform audits for assigned states when new fee schedules are adopted and implemented

Weekly reporting on case submission metrics via SalesForce

Required Qualifications

5+ years of experience as a Business Analyst or Operations/Bill Processing

Ability to demonstrate and communicate system automation

Strong understanding of fee schedules research

Strong analytical and problem-solving skills with high attention to detail

Preferred Experience

Experience in reading and interpreting fee schedules

Experience in healthcare operations and quality improvement initiative

Strong time management skills