Delta Dental

Business Analyst (Claims Operations, Quality Care & Claims)


PayCompetitive
LocationRancho Cordova/California
Employment typeFull-Time

This job is now closed

  • Job Description

      Req#: 2089

      The Business Analyst is responsible for providing analytical support for business operations through research, data gathering and reporting, and interpretation and development of policies and procedures. This position will analyze, document and translate operation requirements into system deployments and business process changes, developing seamless solutions delivered on time, within budget and within scope.

      This role will evaluate end-to-end claims processes, from claims intake to preprocessing, adjudication and post-payment and presentment, to clearly assess process changes and solutions and identify impacts to the business, stakeholders and/or external customers.

      Qualifications

      • 2+ years professional experience with Bachelor’s degree or equivalent experience.
      • Strong analytical and problem-solving skills to evaluate business processes and recommend effective solutions.
      • Advanced proficiency in Excel.
      • Familiar with Power BI or other advanced analytical tools.
      • Knowledge of claims processes is highly preferred.
      • Strong organizational skills that reflect ability to perform and prioritize multiple tasks seamlessly while maintaining excellent attention to detail.
      • Knowledge of process and data-driven structured analysis techniques.
      • Ability to interact with all levels of personnel and communicate clearly in a professional manner.
      • Proficiency with the Microsoft Office Suite


      Base Pay Information

      The national base pay range at the end is a good-faith estimate of what Delta Dental may pay for new hires. Actual pay may vary based on Delta Dental’s assessment of the candidate’s knowledge, skills, abilities (KSAs), related experience, education, certifications and ability to meet required minimum job qualifications. Other factors impacting pay include prevailing wages in the work location and internal equity. $59,000 - $130,900

      Responsibilities

      • Researches and analyzes data and business operations processes to identify trends, potential issues or areas for process improvement opportunities; develops plans and proposal to address issues.
      • Interacts with business stakeholders and subject matter experts to understand business needs and provide guidance to address desired capabilities.
      • Reviews results of processes to ensure success for invoicing, payment, collection, and enrollment activities.
      • Prepares written reports and verbal presentations summarizing project objectives, analysis, conclusions, issues, and recommendations.
      • Communicates with staff and/or project team members to meet project objectives.
      • Develops scope statements for developing project plans to support best practices for change management in collaboration with business sponsor.
      • Creates reports and analyzes data to identify solutions that meet business goals and develops case scenarios in the development of new or enhanced systems.
      • Performs system checkouts and testing for system implementations and periodic builds and releases.
      • Participates in the development and management of project plans from project planning and design through testing, implementation, and maintenance.
      • Develops case scenarios in the development of new or enhanced systems.
      • This list is not all-inclusive and you are expected to perform other duties as requested or assigned
  • About the company

      The Delta Dental Plans Association is composed of 39 independent Delta Dental member companies operating in all 50 states, the District of Columbia and Puerto Rico.

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