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Business Analyst
- Dallas, Texas, United States
- Dallas, Texas, United States
Über
Responsibilities
Analyze prior authorization and claim status datasets to identify trends, performance metrics, and improvement opportunities
Conduct root cause analysis on process inefficiencies, claim denials, and authorization delays
Research and analyze payer clinical policies, medical necessity criteria, and prior auth submission requirements
Monitor customer feedback and product performance to identify enhancement opportunities
Maintain current knowledge of industry standards, payer requirements, and regulatory changes affecting prior authorization workflows and claims processes
Document and map complex healthcare workflows and identify pain points and automation opportunities
Gather business requirements and create detailed user stories, process flows, and functional specifications
Develop and maintain documentation of workflows, data specifications, and product features
Partner with product managers to define and prioritize features based on data insights and customer needs
Participate in product discovery sessions and contribute analytical perspectives
Collaborate with implementation and support teams to identify, document, and resolve product issues and defects
Communicate complex technical and analytical concepts effectively to both technical and non-technical audiences
Qualifications
Bachelor's degree in Business Administration, Computer Science, Healthcare Administration, or related field
1-3 years of experience working with prior authorization and admission notification workflow and claim status processes on the provider and payer sides
Experience working with provider organizations, EHR systems, and RCM platforms; familiarity with EPIC is a plus
Hands‑on experience with AI applications, Payer Guidelines, and Clinical Documentation initiatives
Strong critical thinking skills to address complex healthcare business challenges
Strong data analytical skills, strong SQL and Excel proficiency preferred
Comfortable creating and using process diagrams and flowcharts (MS Visio, Draw IO, etc.)
Excellent written and verbal communication skills
Ability to thrive in a fast‑paced, dynamic environment with shifting priorities
Knowledge of healthcare EDI transactions, including 278 X215/216/217, 837, 835, 276/277, and 270/271 EDI transactions
Must be located in the United States; no sponsorship is available at this time
Travel Requirements This role does occasionally require domestic travel. These travel expectations will be communicated by the department manager or executive. Janus is committed to providing as much flexibility and advanced notice as possible related to scheduling travel.
Physical Demands This job is operated in a professional remote or in‑office environment. This job uses standard office equipment. This job is largely a sedentary role; however, the employee has the flexibility to move as needed. Constantly operates a computer, phone, keyboard, mouse, and other office equipment. The employee frequently communicates with internal and/or external people. Must be able to exchange accurate information in a timely manner. Must be able to recognize objects from short and long distances.
Equal Opportunity Statement Janus is an equal opportunity employer. We hire great people from a wide variety of backgrounds and appreciate our differences. We welcome the unique contributions that you can bring in terms of your education, opinions, culture, ethnicity, race, ancestry, sex, gender identity and expression, national origin, citizenship, marital status, age, languages spoken, veteran status, color, religion, disability, sexual orientation, and beliefs.
We consider qualified applicants regardless of criminal histories, consistent with legal requirements. Further, consistent with applicable federal and state law, Janus provides reasonable accommodation when requested by qualified applicants or employees with disabilities, unless doing so would cause an undue hardship. Janus’ policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If you require reasonable accommodation, please contact the Operations Team.
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Sprachkenntnisse
- English
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