Our goals are to provide excellent service, utilize advanced technology, and proficiently deliver results. To accomplish these goals, we constantly seek individuals who look for ways to do things better. We are a company whose culture cultivates teamwork, rewards excellence, focuses on quality for every aspect of our business, and promotes community involvement. Tabula Rasa HealthCare (TRHC) is a leader in providing patient-specific, data-driven technology and solutions that enable healthcare organizations to optimize performance to improve patient outcomes, reduce hospitalizations, lower healthcare costs, and manage risk. Medication risk management is TRHC's lead offering, and its cloud-based software applications, including EireneRxRegistered and MedWiseTrademark, provide solutions for a range of payers, providers and other healthcare organizations. TRHC empowers our employees to provide excellent service, utilize advanced technology, and proficiently deliver results. Our 32Fundamentals are what we are and who we are. Our culture cultivates teamwork, rewards excellence, focuses on quality for every aspect of our business, and promotes community involvement. As a part of our team, you will help us bring innovative service models to healthcare, improving patient outcomes. CareVention Healthcare is a rapidly growing organization focused on revolutionizing the long-term healthcare ecosystem for the benefit of our members, provider, and payer partners and is working to expand our operational capacity and capability. PeakTPA, a sub-unit of CareVention Healthcare, is responsible for administering the health plans, providing shared services such as member enrollment, call center, claims processing, and authorization processing. Under general supervision, reporting to Peak TPA's SVP, Third-Party Operations with a dotted line to the SVP, CareVention IT, the Sr. Business Analyst provides technical and administrative support to operational areas to ensure that system configuration and data is precise and ready to support the operational and business needs of Peak TPA and its various business partners among CareVention Healthcare. In addition, involvement with configuring and maintaining provider contracts, fee schedules and project management of code sets in the EZ-Cap claims adjudication system. The desirable candidate is expected to communicate professionally with peers, supervisors, subordinates, vendors, customers, and the public, and to be respectful and courteous in the conduct of this position. This is a remote role. ESSENTIAL JOB FUNCTIONS Primary Functions Administration of the PeakTPA EZCap environment - Analyze, design, test and develop system configuration needs to include documentation - Requires adherence to change management standards and preparation of work plans that deliver on schedule and within scope Accountable for in-depth understanding of businessoperational workflows and detailed understanding of new workflow objectives and knowledge of how the enterprise software application functionality will support the business Configure provider contracts and fee schedules in the Citra's EZCap claims adjudication system Works with Sr. Enterprise Application Administrator to coordinate updateschanges to EZCap environment of various code sets to ensure accurate and timely operations Work with the business for the purpose of analysis and documentation of business needs and requirements Develop, implement, and maintain training solutions using a variety of methods, including one-on-one, web-based and classroom training. Customize out-of-the-box training content to better support key business processes as needed Responsible for assessing training needs of the organization's staff to ensure successful incorporation of new workflows and policies and procedures into Enterprise software applications training programs Continually reviewaudit system operations and operating results to ensure consistent application of policies, practices, and optimal system configurations Assist in preparing and maintaining up-to-date documentation of system operating policies and practices Gather data for analysis to assist in system planning and upgrades Ability to extract and synthesize data and conduct and interpret quantitative and qualitative analyses Provide project leadership associated with system upgrades and configurations Systematic analysis, problem solving, and design of workflows, configuration documents, test scenarios and project status reports Use outstanding customer service principals when servicing the needs of the business users Comply with the organization's Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls Complete special projects and other duties as assigned QUALIFICATION REQUIREMENTS EDUCATION, EXPERIENCE TRAINING Bachelor's degree in a technical field or equivalent practical experience 10+ years of Healthcare Business Analysis andor product management experience with the following Must have strong experience working with EZCap (front-end back-end proficiency) Experience with other claims systems a plus Excellent communication and experience working across multiple teams (engineering, testing, business, etc.) Benefit, claims configuration, and pricing configuration Familiarity with Provider contracts and fee schedules Advance SQL Queries and strong Excel (Pivot tables, V-Lookups, Formulas) a plus Knowledge and understanding of Medical Claim Forms and EDI (X12) Strong understanding of modifiers and NCCI edits Knowledge of patient billing terminology, collections as well as Medicare and Medicare Advantage billing, rules and regulations and compliance Must be quality and process-oriented Must be able to perform in a high- volumetime-sensitive production environment Must be PC proficient Experience working in a highly regulated environment (SOX, HIPAA, HITRUST) PREFERRED SKILLS Government Program Experience (Medicare, Medicaid, PACE, DNSP) a plus System Migration experience a plus Medicare Reimbursement Denial experience preferred DICE The Company is proud to be an equal opportunity employer. All qualified applicants will receive consideration without regard to ancestry or national origin, race or color, religion or creed, age, disability, AIDSHIV, gender, marital or family status, pregnancy, childbirth or related medical conditions, genetic information, military service, protected caregiver obligations, sexual orientation, protected financial status or other classification protected by applicable law. Other details Job Function IT - Infrastructure Pay Type Salary Travel Required No Telecommute 100 Required Education Bachelor's Degree Apply Now Irvine, CA, USA