Systems Analyst II
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Rising Medical Solutions
IN
Summary
The Systems Analyst II will translate business requirements into technical specifications and collaborate with developers to implement system enhancements. They will also act as a subject matter expert for system integrations and provide production support through root cause analysis.
Job Description
Rising Medical Solutions has an opening for a Systems Analyst II, and we want to hear from you! We're a bill review and cost containment company - so what does that mean? Basically we are trying to fix a very broken healthcare system by reducing the cost of healthcare claims through bill review, case management, and utilization review. Our mission is "We make lives better" and everyone here at Rising works hard to achieve this goal. So take a look at the job, let us know what you think, and let's start working towards a better future!
What You'll Be Doing
- Translate business requirements into technical requirements and ensure all system requirements adequately reflect defined business processes and fully support all components of the functional business requirements
- Communicate requirements and collaborate with developers, QA analysts, and other project team members to implement or enhance systems
- Represent Rising in client and partner meetings for system implementations
- Develop a subject matter expertise on one or more aspects of integrations between company and external systems and/or internal systems
- Assist with production support - investigate issues, root cause analysis, report and communicate detailed findings when necessary
- Develop use cases and process/data flow diagrams
- Support the creation and/or create test plans and relevant training materials
- Conduct reviews of systems and identify enhancements that support company strategies and affect key performance indicators
- Conduct training for other Professional Services team members for subject matter knowledge transfers
Education
- A Bachelor’s degree or equivalent, preferably in an IT-related field
Experience
- A minimum of two full years of experience in a business systems analyst or equivalent role
- Must have experience with workers’ compensation insurance, group health insurance, medical bill review, and/or relevant health care industry systems and processes
- Must have experience with requirements analysis, interacting with business users to define clear scope, and contributing to cross-functional teams
- Excellent analytical, communication, and problem-solving skills, and experience applying these skills to resolve application design considerations and technical issues
- Must have working knowledge of database and data modeling tools and concepts
- Must have working knowledge of business-to-business data transactions and experience writing detailed mapping instructions to transfer data between distinct models
- Must have experience analyzing XML or EDI messages
- Strong working knowledge of SQL and database concepts to aid in data analysis
- Ability to communicate technical information clearly and participate in collaborative meetings with representatives from internal departments and clients
- Skill in the use of computerized spreadsheet, relational database, and word processing software
- Ability to process computer data and to format and generate reports
- Must have experience creating detailed visual models to support requirements including data flow/workflow diagrams
- Ability to conform to shifting priorities, demands, and timelines
- Ability to quantify results in terms of cost savings and key performance indicators
- Demonstrated history of proactively identifying improvement opportunities in systems and methodologies
- Generous Flexible Time Off (take it when you need it!)
- Comprehensive benefit package including health/dental/vision insurance, profit sharing, and 401k matching
- Career Growth Opportunities - We often promote from within
- Professional Development Reimbursement Program (PDRP)
- You will be part of our new Elevate program designed to recognize and reward employees for their hard work
- Rising was named a Top Workplace in the healthcare industry for 2023! Check out our profile here: Working at Rising Medical Solutions | Top Workplaces
- We're on YouTube! Check out our culture at: http://www.youtube.com/user/RisingMedical
- Want to see more? Check out our:
- Facebook: https://www.facebook.com/RisingMedicalSolutions
- LinkedIn: http://www.linkedin.com/company/rising-medical-sol..
If you are ready to join a team of professionals dedicated to making a difference and making lives better, please apply today!
Rising Medical Solutions is a national managed care firm that provides medical cost containment and medical care management services to the workers' compensation, auto, liability, and group health markets. Our client base includes insurance carriers, TPAs, self-insured employers, and public-sector and government entities of varying sizes from small to large tier.
Since 1999, our managed care services have positively impacted hundreds of thousands of employee lives and saved billions in total claim costs for payers across the country. Our flagship bill review service and technologies consistently deliver over 60% in national bill review savings, which includes application of fee schedule/UCR rates, network discounts, nurse audits, provider negotiations, and embedded fraud detection capabilities.
However, our solutions portfolio goes far beyond the standard repricing of medical bills. Our integrated programs deliver clinical and cost-saving expertise before, during, and after treatment. Our proprietary VISION™ platform is the industry’s only multi-product, multi-line, single-sign-on, medical management enterprise system. VISION™ provides claims professionals with unprecedented ancillary referral and medical management capabilities across the entire medical care continuum, from early intervention to payment processing. Together with our passionate, mission-driven employees, Rising delivers an unparalleled user experience for those providing, receiving, and paying for medical care.
Rising also directs and publishes the annual Workers’ Compensation Benchmarking Study, a national research program examining the complex forces impacting claims management in workers’ compensation today. The study has become one of the most cited research publications in the industry and has been the subject of numerous articles, webinars, and conference presentations since its 2013 inception.
Founded
1999
Company size
51-200 employees
Industry
Insurance
Org type
Privately Held
Headquarters
Chicago, IL
Rising Medical Solutions is a national managed care firm that provides medical cost containment and medical care management services to the workers' compensation, auto, liability, and group health markets. Our client base includes insurance carriers, TPAs, self-insured employers, and public-sector and government entities of varying sizes from small to large tier.
Since 1999, our managed care services have positively impacted hundreds of thousands of employee lives and saved billions in total claim costs for payers across the country. Our flagship bill review service and technologies consistently deliver over 60% in national bill review savings, which includes application of fee schedule/UCR rates, network discounts, nurse audits, provider negotiations, and embedded fraud detection capabilities.
However, our solutions portfolio goes far beyond the standard repricing of medical bills. Our integrated programs deliver clinical and cost-saving expertise before, during, and after treatment. Our proprietary VISION™ platform is the industry’s only multi-product, multi-line, single-sign-on, medical management enterprise system. VISION™ provides claims professionals with unprecedented ancillary referral and medical management capabilities across the entire medical care continuum, from early intervention to payment processing. Together with our passionate, mission-driven employees, Rising delivers an unparalleled user experience for those providing, receiving, and paying for medical care.
Rising also directs and publishes the annual Workers’ Compensation Benchmarking Study, a national research program examining the complex forces impacting claims management in workers’ compensation today. The study has become one of the most cited research publications in the industry and has been the subject of numerous articles, webinars, and conference presentations since its 2013 inception.
Founded
1999
Company size
51-200 employees
Industry
Insurance
Org type
Privately Held
Headquarters
Chicago, IL
