Carc – Business Analyst III
| Company | Centene |
|---|---|
| Location | New Mexico, USA, Washington, USA, Kansas, USA, Pennsylvania, USA, North Dakota, USA, Oregon, USA, Delaware, USA, Iowa, USA, California, USA, Washington, DC, USA, Vermont, USA, Wyoming, USA, Texas, USA, Montana, USA, Jackson Township, NJ, USA, Florida, USA, Waterbury, CT, USA, Nevada, USA, South Carolina, USA, South Dakota, USA, Georgia, USA, Arizona, USA, Concord, NH, USA, Mississippi, USA, Tennessee, USA, Virginia, USA, Arkansas, USA, Minnesota, USA, Colorado, USA, Rhode Island, USA, Utah, USA, Northeastern United States, USA, Kentucky, USA, West Virginia, USA, New York, NY, USA, Maryland, USA, Hawaii, USA, Wisconsin, USA, Maine, USA, Massachusetts, USA, North Carolina, USA, Oklahoma, USA, Missouri, USA, Ohio, USA, Louisiana, USA, Alaska, USA, Michigan, USA, Illinois, USA, Alabama, USA, United States, Idaho, USA |
| Salary | $68700 – $123700 |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Mid Level, Senior |
Requirements
- Bachelor’s degree in related field or equivalent experience
- 4-6 years of business process or data analysis experience, preferably in healthcare
- Project management experience preferred
- Prior experience with creating/maintaining claim explanation codes preferred
- Prior experience with CARC (Claim Adjustment Reason Codes), RARC (Remittance Advice Remark Codes), and CAQH (The Council for Affordable Quality Healthcare) highly preferred
Responsibilities
- Manage the ticketing process across all claim platforms specific to creating new, or modifying current, claim explanation codes and connecting the correct CARC & RARC codes
- 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
- Performs other duties as assigned
- Complies with all policies and standards
Preferred Qualifications
- Project management experience preferred
- Prior experience with creating/maintaining claim explanation codes preferred
- Prior experience with CARC (Claim Adjustment Reason Codes), RARC (Remittance Advice Remark Codes), and CAQH (The Council for Affordable Quality Healthcare) highly preferred