BCforward

Operations Business Analyst

BCforward is currently seeking a highly motivated Operations Business Analyst in Remote.

Position Title: Operations Business Analyst

Location: Fully Remote

Anticipated Start Date: 1st-July-2025

Please note this is the target date and is subject to change. BCforward will send official notice ahead of a confirmed start date.

Expected Duration: 24 Months contract to hire

Job Type: [FULL TIME (>%3D40 HRS WEEKLY), [CONTRACT], [Remote]

Pay Range: $20.00/hr - $21.90/hr

Please note that actual compensation may vary within this range due to factors such as location, experience, and job responsibilities, and does not encompass additional non-standard compensation (e.g., benefits, paid time off, per diem, etc.).

Job Description:

BG in medical processing or claims is preferred. Needs to have mid-level proficiency in Excel. Working knowledge of SQL would be helpful.

We are seeking a highly motivated and detail-oriented Operations Business Analyst to join our team. This position is responsible for the daily posting and accounts receivable (AR) reconciliation of medical payments to claims, based on both paper and electronic Explanation of Benefits (EOBs) from insurance carriers. The analyst will correct errors, modify posting issues, and generate monthly invoices based on claims processed during the reporting period.

This role requires strong problem-solving skills, the ability to work independently in a remote environment, and experience in healthcare claims. The ideal candidate will be comfortable navigating complex systems and processes and have a deep understanding of medical and pharmacy claims adjudication, Medicaid reclamation, and healthcare payment cycles.

Key Responsibilities:

• Post payments to medical and pharmacy claims from paper and electronic EOBs daily.
• Reconcile AR and correct any discrepancies or posting issues.
• Identify, analyze, and resolve errors in claim postings and payments.
• Participates in meetings with client engagement to gather and document requirements and explore potential solutions.
• Assists in analyzing and documenting client's business requirements and processes following established approach and methodology; communicates these requirements to technical personnel.
• Plans and designs standard business processes following established approach and methodology; assists in formulating recommendations to improve and support business activities.
• Develops and modifies systems requirements documentation to meet client needs.
• Generate and distribute monthly invoices using PeopleSoft Finance based on claims posted during the reporting period.
• Create, run, and deliver posting and reconciliation reports; analyze trends and anomalies.
• Use FTP protocols to securely transfer files from various sources.
• Maintain accurate documentation for audit and compliance purposes.
• Collaborate with other departments to resolve issues related to claims and payments.
• Work independently in a remote environment while meeting deadlines and service level agreements (SLAs).

Required Qualifications:

• Bachelor's degree in Business, Healthcare Administration, Finance, or a related field; OR 3-5 years of experience in medical claims posting and reconciliation.
• Solid understanding of medical and pharmacy claims adjudication and Medicaid reclamation claims.
• Proficiency in SQL and ability to extract and analyze data from relational databases.
• Familiarity with PeopleSoft Finance or similar enterprise financial systems.
• Strong critical thinking and problem-solving skills; able to troubleshoot independently.
• Experience with FTP protocols and secure file transfer.
• Excellent written and verbal communication skills.
• Strong attention to detail and organizational skills.

Benefits:

BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.

About BCforward:

Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCforward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.

This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.

Interested candidates please send resume in Word format Please reference job code 239724 when responding to this ad.