Quality Business Analyst - Top Stack

Seeking a Quality Business Analyst with experience in claims processing, auditing, and compliance to manage Federal Employee Program (FEP) transactions, support audits, ensure adherence to FEP performance metrics, and develop process improvements in a production environment.
 
 
RESPONSIBILITIES/COMPANY HIGHLIGHTS:

• Process claims tasks, including inquiries, reconsiderations, and adjustments, to meet FEP performance metrics.
• Review FEP procedures, regulations, and controls, incorporating them into specifications or documentation.
• Identify and implement process improvements, including developing workflows and system recommendations.
• Communicate effectively with internal and external stakeholders.
• Engage in ongoing training to stay updated on systems and regulations.

 
QUALIFICATIONS:

• High School Diploma/GED with 4+ years in claims/service operations, or Associate degree with 2+ years in Federal Employee Health Benefits Plan (Bachelor's preferred).
• In-depth knowledge of FEP policies, processing standards, and guidelines.
• Experience in auditing, quality review, or transaction processing.
• Team-oriented, adaptable, with a proven ability to identify and assess process improvement opportunities.