• Collecting/analyzing, report status, metrics and trends of activity by different reviews from multiple systems • Distributing reports on a routine basis to specific distribution group • Managing Epic work queues and resolving denials. • Gathering data to substantiate the request for rule creations in Epic. • Research payer fee schedules and provider manuals to ensure appropriate non covered denials. • Organizing all data and activity in a retrievable way • Coordinating payor denial and audit activities to ensure timely response for the processing of all payor denials, audit request and appeals for both institutional and professional claims • Assisting with the coordination of denial and review activities and materials for committee meetings, including analyses, reports, etc. • Communicating and coordinating with various individuals/distributions and assisting with monitoring of the day-to-day activities related to claim denials and audit reviews • Maintaining the healthcare tracking tool/application that stores/communicates all denial and review activity. This will include user access management, updates to software, and end-user training • Supporting projects and initiatives of the Denials Management Team. This may include coordinating meetings, conducting research, performing audits or data analysis, and preparing documents

• Seeking a seasoned, results-focused Senior Business Analyst who combines P&C insurance industry knowledge. • Leading projects to support our rapidly expanding Sharing Economy business. • Establishing innovative, high-quality technical solutions to address complex business challenges. • A tenacious, highly independent self-starter who thrives in fast-paced environments. • Navigating ambiguity to deliver clear, actionable results. • History of achieving measurable results and successfully delivering on business objectives.

• Coordinates the service request life cycle through customer-related service request responses, business requirements coordination, technical specifications and related artifacts review, and monitors system integration and user acceptance testing prior to implementation. • Coordinates the analysis of program policies and procedures to determine their effect on automated systems and system functional areas. • Coordinates and/or analyzes user requirements, procedures, and problems to automate or improve existing systems; and coordinates and/or analyzes computer system capabilities, workflow, and scheduling limitations. • Coordinates with outside vendors and contractors to complete projects and service requests; and defines, assigns, and evaluates their work. Identifies opportunities for improving business processes through automation and assists in the preparation of proposals to develop new systems. • Identifies potential project risks and difficulties, and designs strategies to mitigate or avoid them. • Reviews complex project deliverables such as project charters, design documentation, test plans, and risk assessment plans, and provides comments and suggestions to document owners. • Consults on the analysis of an application, troubleshoots system problems, and implements solutions. • Provides complex quality assurance consultation to, or oversight of, projects, assignments, or special initiatives. • Develops training curriculum and conducts formal training sessions covering assigned systems module. • Develops the design and/or review of test cases; processes change requests; and manages a project’s scope, acceptance, installation, and deployment. • Performs related work as assigned.

• Manage claim volume distribution and optimizing operational workflows. • Forecast staffing needs across claims units. • Create, maintain, and update real-time Claims Volume Reports. • Maintain Workforce Management tools, ensuring accurate routing and compliance. • Monitor claim volume and adjust administrative functions. • Evaluate and negotiate within settlement authority with insureds and claimants. • Demonstrate proficiency with estimates and claims technology. • Coordinate with internal and external departments as required. • Respond quickly to customer needs and inquiries. • Overtime and holiday hours may be required.