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 or process improvement, with at least two major transformations executed.
  • 5+ years of experience generating and analyzing operational reports.
  • 3+ years working in bill/claims processing systems within the Workers Compensation industry across various jurisdictions.
  • Demonstrated experience in project and change management.
  • Strong client-facing and internal communication skills. Focus on writing and verbal proficiency.
  • Excellent organizational and multitasking abilities, with attention to detail.
  • Proficient in Microsoft Office and Visio; Bachelor's degree in relevant field or equivalent experience.

Responsibilities

  • Serve as the subject matter expert on system configuration and bill review processes.
  • Collaborate with Bill Review leadership to execute process changes and system reconfiguration.
  • Conduct data analysis and performance trending for process control improvements.
  • Develop communication plans for stakeholders regarding re-engineering initiatives.
  • Inform teams about strategies for process improvement and restructuring.
  • Coordinate compliance audits with the Clinical Bill Review department.
  • Perform testing and support for data reporting processes and requirements.
  • Update system configuration documentation as changes occur.
  • Support Project and Program Managers in key initiatives.

Benefits

  • Comprehensive health insurance options, including PPO, HDHP, and HMO plans.
  • 401(k) matching contributions and financial benefits for employee security.
  • Generous paid time off policies promoting work-life balance.
  • One paid volunteer day per year to support community engagement.
  • Ongoing professional development opportunities through the LEAP program.
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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