Business Analyst (Troy, MI)

$60,000 - $65,000/Yr

Benesys - Troy, MI

Full-time - Entry Level

Remote - Troy, MI

Insurance Carriers and Related Activities

About the position

We are seeking a motivated self-starter to join our team as a Business Analyst. This role involves working with the Plan Build team to review Summary Plan Definitions (SPDs) and configure Plan Benefits in our SpyGlass claims module. The ideal candidate will have a background in health insurance or Software as a Service (SaaS), although this is not a strict requirement. The position requires a team player who is enthusiastic and eager to learn, located in the Metro Detroit area, and able to commute to our Troy, MI office.

Responsibilities

• Interpret Summary Plan Descriptions
• Set up benefits for Medical, Vision, Dental, Flex, and Short-Term Disability Plans
• Maintain the logic that drives claims to the Benefit codes using HCFA or UB-04 fields
• Maintain Category Definitions used in logic
• Identify methods to improve auto-adjudication
• Create benefit outlines for new or converting Funds
• Make revisions to benefit outlines when a Fund has a plan or system change
• Document and track Plan change requests in the IT ticket system
• Assist with standard and custom reports related to claims
• Test new system releases and interim patches
• Troubleshoot claims processing and system issues
• Review accuracy of converted claims history and accumulators when new Funds are implemented
• Document procedures
• Provide analysis, definition, and direction to computer applications related development and maintenance activities
• Ensure correct business functionality, requirements, and industry standards are addressed within the software application
• Maintain regular and predictable attendance.

Requirements

• Bachelor's degree or higher preferred
• Experience working in medical claims processing, medical coding, or software configuration
• Enthusiasm for learning new things and willingness to become a subject matter expert in Spyglass
• Excellent communication skills (written and verbal)
• Ability to calculate accumulators involved in claims processing, such as different out of pocket and coordination of benefit methodologies.

Nice-to-haves

• Background knowledge in health insurance
• Experience with Software as a Service (SaaS)

Benefits

• 401(k) matching
• AD&D insurance
• Dental insurance
• Dependent health insurance coverage
• Disability insurance
• Health insurance
• Paid holidays
• 15 days Paid Time Off (PTO) during first full calendar-year of service
• 12 paid holidays
• 3 days paid bereavement
• Up to 20 days paid jury leave
• Company-paid basic life, short-term disability, long-term disability, and AD&D insurance
• Tuition reimbursement program
• Career development opportunities
• Referral bonus for all successful full-time referrals
• Annual opportunities for increases