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Business Analyst

APWU Health Plan
Glen Burnie, MD
  • Expired: over a month ago. Applications are no longer accepted.
Job Description

POSITION PURPOSE:

To support and enhance the quality and quantity of production operations through on-line maintenance of business systems, recommending improved methods/alternatives for operations.

PRIMARY ACCOUNTABILITIES:

Maintain benefits, configuration and fee schedules in QNXT.

Conduct testing of system changes. Actively participate in QNXT system upgrades

Has ability to troubleshoot, create the root cause analysis, and propose solutions for issues found in:

  • Claims Payment
  • Claims accumulators
  • Benefit configuration
  • Provider
  • Contract configuration
  • Membership and Enrollment
  • Authorization
  • Program set-up

Coordinate with Division Manager, Configuration/Testing Manager, Manager, Applications Development and Support and/or Team Lead, Applications Development to assure priority of new work.

Complete other duties as assigned.

QUALIFICATIONS:

B.S. degree in Business, Economics, Public Health or Computer Science preferred, but direct experience may be substituted.

A minimum of three to five years of QNXT experience as a Business Analyst, Senior Business Analyst or Lead Test Analyst.

Thorough understanding of all aspects of the QNXT claims processing system - including (but not limited to) claim adjudication, membership and enrollment, eligibility, configuration and benefits, authorizations and payment.

Excellent technical and analytical skills.

Good verbal and written communication skills.  Ability to render and write business requirements as technical documentation and business decision documentation.

Proficiency in requirements gathering - effectively translating business needs as expressed by users into workable specs, estimating time\duration to complete and implement the solution. 

TECHINICAL SKILLS

Expert knowledge of the QNXT Claims Application

Microsoft SQL experience

  • Write SQL queries to support technical design documents
  • Write SQL to support troubleshooting activities
  • Write SQL queries to support testing / validation activities

Ability to read HIPAA transactions 278; 834; 835; 837I, P, D and follow data mapping into QNXT – Preferred

Company Description
The American Postal Workers Union (APWU) Health Plan is a national preferred provider organization (PPO) that offers both a fee-for-service High Option plan and a Consumer Driven Option health plan. Both options are open to all employees or retirees covered under the Federal Employees Health Benefits (FEHB) Program. Located in Glen Burnie, Maryland, the Health Plan is a department of the American Postal Workers Union. We employ 200 people to service the 205,000 people covered by the Health Plan.

EEO M/F/D/V; Drug-Free Employer

APWU Health Plan

Why Work Here?
APWU Health Plan is a great place to work.

The American Postal Workers Union (APWU) Health Plan is a national preferred provider organization (PPO) that offers both a fee-for-service High Option plan and a Consumer Driven Option health plan. Both options are open to all employees or retirees covered under the Federal Employees Health Benefits (FEHB) Program. Located in Glen Burnie, Maryland, the Health Plan is a department of the American Postal Workers Union. We employ 200 people to service the 205,000 people covered by the Health Plan. EEO M/F/D/V; Drug-Free Employer

Address

Glen Burnie, MD
USA

Industry

Business

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