Business Analyst (Medical Bill Review Experience Preferred)

Company Details

 

Berkley Medical Management Solutions (BMMS) provides a different kind of managed-care service for W.R. Berkley Corporation. We believe focusing on an injured worker’s successful and speedy return to work is good for people and good for Berkley’s insurance operating units. BMMS was first started in 2014 by reimagining the relationship between medical need and technology to deliver the best outcome for injured workers and Berkley’s operating units. Our goal was clear: combine solid clinical practices, proven return-to-work strategies and robust software into one system for seamless management of workers’ compensation cases.

 

To get it right, we started with a flexible technology platform that allowed for impressive customization without sacrificing the ability for expansion and continued innovation. We deploy integrated systems to give W.R. Berkley Companies recommendations and professional services for managing each individual case in an efficient and appropriate manner. The power of our technology takes medical bill-review services and clinical advisory services to a new level. Our unique marriage of technology, software platforms, data analytics and professional services ensures we provide Berkley’s operating units with reliable results, and reduced time and expenses associated with case management.

Responsibilities

As a Business Analyst, you’ll play a critical role in helping BMMS reach its goals by carrying-out the Business Analyst “Key Functions” outlined below. The Business Analyst is multi-faceted and acts as a liaison between business, operations, other business analysts, and IT resources internal to BMMS and external with BMMS’ vendors and Berkley sister companies.  The Business Analyst’s objective is to perform the business analysis function to help BMMS achieve strategic, project based, and department level success wherever a business analysis resource is deemed appropriate and is deployed, and help educate fellow team members on Active Listening, Balanced Approach, Boldness, Critical Thinking, Integrity, and Quality Decision Making.

 

• Determine business analysis work that will be required during the planning phase of projects and process improvement efforts.
• Elicit and document business requirements for projects, including core product build & enhancements and implementations; business process workflows, service management issues; &/or identified opportunities for improvement.  Requirements may include but are not limited to those that result in business and IT-based solutions including coding, configuration, EDI, reporting, process workflow, etc. These may impact BMMS only or BMMS’ vendors &/or Berkley sister company systems/programs.  Elicitation activities include leading large groups of diverse people within all levels of the organizations through detailed requirements gathering sessions.
• Analyze business requirements to verify clarity and completeness with business owners; validate every requirement gathered belongs within the scope of project or assignment by comparing it to the stated business need & objective; confirm & document assumptions and constraints.
• Analyze proposed solutions with the business owner and impacted IT &/or operational areas for clarity and completeness.  Solutions may include changes or enhancements to systems/programs &/or operational workflows and may have impacts only internal to BMMS, to BMMS’ vendors, &/or to Berkley sister companies.
• Document high-level business requirements and/or detailed IT specifications using department-approved templates/formats (where applicable) to produce requirements artifacts that may include: Business Requirements Documents (“BRDs”), Policy & Procedure documents (“P&Ps”), IT Functional Specifications/User Stories, Report Specifications, Workflow Documents (Visios). 
• Contribute to test design, planning, scenario-building, and validation.
• For service management issues:  Identify root cause(s); lead resolution for specific issues; document issue, progress, and resolution clearly/completely in accordance with department standards; follow-up on root cause and lead root cause resolution with necessary business owner escalations & approvals.
• Assist department in fulfilling goals and objectives by carrying-out other duties as assigned.
• Mentor Associate Business Analysts.
• Identify areas for improvement in department processes and raise recommendations to management.

Qualifications

• Minimum 2-4 years of experience in a business analyst role with similar functions demonstrating increasing level of responsibility over time required.
• Workers’ compensation, medical billing, or managed care service industry experience strongly desired.
• Demonstrated ability to successfully manage multiple complex assignments at one time employing multiple of the position’s essential functions independently.
• Experience managing requirements within the scope of a project required.
• Experience with writing detailed IT specifications strongly desired.
• Ability to operate computers including working knowledge of major Microsoft Office applications including MS Word; Excel; Power Point; Visio.

Education Requirement

• Bachelor’s Degree preferred, Certificate in Business Analysis a plus.  

Additional Company Details

The Company is an equal employment opportunity employer. Important Outside Agency Notice: Only solicited resumes/candidate profiles that are submitted by a Berkley Preferred Agency Partner that have been requested by Berkley Internal Recruiting to engage in a particular search will be subject to the payment of Agency fees as defined in the formal agency agreement. Any unsolicited resumes/candidate profiles are not subject to payment of the agency fees. The company offers a competitive compensation plan and robust benefits package for full time regular employees Salary Range: $65,000-$88,000 • Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

Additional Requirements

Travel Requirements Domestic U.S. travel required (up to 10% of time)