Business Analyst - Claims

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Make It Happen At Hopkins!

Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine, one of the premier health delivery, academic, and research institutions in the United States.  JHHP is a $2.5B business serving over 400,000 lives with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments.  JHHP has become a leader in provider-sponsored health plans and is poised for future growth. 

What awaits you: 

• Work-life balance -  This is a remote role. 


• Medical, Dental, and Vision Insurance.


• 403B Savings Plan w/employer contribution.


• Generous Paid Time Off 


• Health and wellness programs and MORE!

About this position:

The Claims Business Analyst is responsible for researching claims issues, identifying root cause, and creating reporting to identifying claims denial reasons and trending in order to make recommendations for resolution. This person will work with Provider Relations, Systems Configuration, and the Adjustments department to solve claims processing and payment issues. The claims business analyst will be able to take claims processing issues identify the root cause, work through any necessary system configuration and/or processing issues with the appropriate departments, and work with the applicable departments to resolve root cause and ensure impacted claims are processed correctly.

Requirements:

Education: 

• Bachelor’s Degree in Business, HealthCare Management or related field preferred. Additional related work experience may substitute for some educational requirements.

Work Experience:

• Requires a minimum of 3 - 5 years’ experience in medical claims or adjustment processing in a health plan environment.