Business Analyst II

Elevance Health • Tampa, FL

21h • Hybrid

About The Position

This role is crucial in recovery operations, where the BA II engages with various stakeholders to gather essential data to understand billing and payment requirements, and pinpoint sources of overpayments. While collaborating with the query team, the BA II helps establish necessary business requirements for overpayment concepts used to identify related claims.

Requirements

• Requires a BA/BS and minimum of 3 years related business analysis experience, or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

• Experience with Medicaid, Medicare, Commercial lines of business preferred
• Claims Processing Experience is a must
• COB experience strongly preferred
• Data analysis experience preferred
• GBD FACETS experience Preferred
• WGS experience Nice to have
• Attention to detail strongly preferred

Responsibilities

• Serving as a liaison, the BA II works closely with Health Plans and their staff to address workflow inquiries, adapt to evolving concepts/tasks, and ensure that financial targets are consistently met
• Responsible for researching and maintaining comprehensive documentation, such as policies, manuals, and contracts, which support operational transparency
• Crafts validation instructions to guide downstream departments in accurately reviewing claims related to overpayment scenarios
• Strong writing skills are essential for drafting clear, precise communication for provider letters that explain overpayment reasons
• Manage Ad Hoc recovery initiatives and handle monthly low-complexity recurring leads, while analyzing recovery reports to enhance claim validation accuracy and identify areas for process improvement
• This position offers an opportunity for foundational growth and development within the Payment Integrity sector

Benefits

• We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees