Worker's Compensation Bill Review Systems Analyst

Paradigm

$75K — $95K *
Finance & Insurance
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 5+ years in process/systems analysis and improvement, including executing two major transformations.
  • 5+ years in generating and analyzing reports in operations context.
  • 3+ years in Workers Compensation claims processing across multiple jurisdictions.
  • Proven experience in project and change management.
  • Excellent communication skills for both client-facing and internal interactions.
  • Strong organizational skills with attention to detail and multitasking.
  • Bachelor's Degree in a relevant field or equivalent work experience.

Responsibilities

  • Act as the subject matter expert for system configuration and bill review processes.
  • Collaborate with Bill Review leaders to implement process changes and system configurations.
  • Conduct data gathering, root cause analysis, and performance trending to enhance processes.
  • Prepare and execute communication plans for process improvement across stakeholders.
  • Inform teams about strategies for process re-engineering and improvement.
  • Coordinate compliance audits and review activities with the Clinical Bill Review department.
  • Support testing and documentation efforts related to data reporting processes.
  • Assist project and program managers in strategic initiatives.

Benefits

  • Health insurance options with Cigna and Kaiser (CA employees only).
  • 401(k) matching contributions and employer-paid life/disability insurance.
  • Flexible paid time off to support work-life balance.
  • One paid volunteer day per year for community engagement.
  • Support for continuous learning through programs like LEAP.
Full Job Description
We are seeking a full-time, remote Worker's Compensation Bill Review Systems Analyst. The Bill Review Process Analyst is responsible for analyzing Bill Review operational processes to identify and implement changes to improve productivity, reliability, quality, and efficiency and serves as the system administrator and subject matter expert. The ideal candidate will have experience implementing system change (rule writing, etc.) on a worker's compensation bill review system (Smart Advisor or similar), analytical skills, and familiarity with state/NCCI reporting. The schedule for this position is Monday - Friday, 8 AM to 5 PM Central Time. This position may require travel 1-2 times per year. Responsibilities include (but are not limited to): - Serve as system configuration subject matter expert: understand, document, and be able to explain how the bill review system applies rules and settings to process bills. - Work closely with Bill Review leaders to implement any changes to bill review processes including editing of rules and configuration / reconfiguration of systems - Perform data gathering, root cause analysis and performance trending in order to develop appropriate process control changes - Prepare communication plans regarding process re-engineering for multiple stakeholders - Inform respective teams on process improvement and re-engineering strategies - Coordinate internal compliance auditing, monitoring and review activities in conjunction with the Clinical Bill Review department - Provide testing and system support in relation to data reporting processes and requirements - Update and maintain documentation on system configuration as changes are implemented - Assist Project Managers and Program Managers in strategic projects and key initiatives - Identify and resolve company, state/NCCI reporting, and/or client data issues, including with vendors as applicable REQUIRED: - 5+ years' experience in process/systems analysis, engineering, and/or process improvement including executing at least two major process creations or transformations - 5+ year's experience generating and analyzing reports to monitor productivity, throughput, and/or other operational KPIs - 3+ Years' experience working in bill/claims processing systems in the Workers Compensation industry across multiple jurisdictions. - Proven working experience in project and change management - Excellent client-facing and internal communication skills - Excellent written and verbal communication skills - Solid organizational skills including attention to detail and multitasking skills - Strong working knowledge of Microsoft Office and Visio - Bachelor's Degree in appropriate field of study or equivalent work experience Paradigm Benefits: - Health and wellness- We want our people to be and stay healthy, so we offer PPO, HDHP, and HMO health insurance options with Cigna and Kaiser (CA employees only). - Financial incentives - Paradigm's financial benefits help prepare you for the future: competitive salaries, 401(k) matching contributions, employer-paid life and disability insurance, flexible spending and commuter accounts, and employer-matched HSA contributions. - Vacation - We believe strongly that work-life balance is good for you and for our company. Our paid time off and personal holiday programs give you the flexibility you need to live your life to the fullest. - Volunteer time- We want our employees to engage with and give back to their communities in meaningful ways. Full and part-time employees receive one paid day per calendar year. - Learning and development: One of Paradigm's core values is expertise, so we encourage our employees to continually learn and grow. We support this in a variety of ways, including our new Learning Excellence at Paradigm (LEAP) program.

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