Derex Technologies Inc specializes in providing IT consulting, staffing solutions and software services. Globally headquartered in Harrison New Jersey since 1996 Derex delivers the highest quality technology professionals and an array of customized IT talent solutions designed to improve productivity and drive results to global clients throughout North America.
With over two decades of unparalleled experience, Derex provides supports to its clientele, across such industries as Systems Integration, Banking and Finance, Telecommunications, Pharmaceutical and Life Sciences, Energy, Healthcare, Technology, Transportation, and local and federal Government agencies.
Position: Healthcare Business Analyst (Claims and Pre-Authorization)
Location: Parsippany-Troy Hills, NJ, USA(On-Site)
Job Description
Overview:
As a Healthcare Business Analyst specializing in claims processing and pre-authorization, you will play a critical role in optimizing the development of our products. Your expertise will contribute to efficient claims management, accurate pre-authorization decisions, and streamlined processes.
Responsibilities:
• Analyze end-to-end claims workflows, from submission to payment.
• Collaborate with stakeholders (insurers, providers, patients) to identify process improvements.
• Understand how to Ensure compliance with industry standards (e.g., HIPAA)
• Evaluate pre-authorization requests for medical services or procedures.
• Verify medical necessity and adherence to guidelines.
• Facilitate timely approvals by working closely with providers and payers.
• Utilize tools like Excel, SQL, and data visualization platforms.
• Create reports, dashboards, and presentations to communicate insights.
• Monitor performance metrics related to claims and pre-authorization.
• Collaborate with IT teams to enhance products and development of claims processing systems.
• Gather requirements for system upgrades and new features.
• Maintain strong communication with cross-functional business units.
Regards,
Manoj
Derex Technologies INC
Contact : 973-834-5005 Ext 206
All your information will be kept confidential according to EEO guidelines.
Requisition ID: 107895 Share Our Purpose. Be Yourself. Feel Valued. People are the heart of our business. As an American Water employee, you will be offered a competitive salary and health benefits package, along with opportunities to develop, grow, and evolve...
...seeking opportunities to expand knowledge, skills, and expertise throughout your career journey.Embrace remote work options in telemedicine or virtual healthcare settings, leveraging technology to deliver care from anywhere while maintaining professional engagement.Stay...
...Description *IN SCHOOL OR GRADUATED WITHIN THE LAST 12 MONTHS? PLEASE VISIT FUTURE FORCE... ...Note: By applying to the Full-Stack Software Engineer Application Development posting... ...groups and review designs of others Develop test strategies, design automation frameworks...
...CAD Operator HVAC & Mechanical Construction Location: Columbia, SC Company: Walker White Mechanical Job Type: Full-Time | In-Office | Monday to Friday Experience Level: Mid-Level (2+ Years Preferred) Industry: Construction, HVAC, Mechanical Contracting...
UX Writer, Regulatory and Compliance**Culver City, California, United States****Design****Summary**Posted: **Feb 07, 2025**Weekly Hours: **40**Role Number: **200588880**Apple is where people do the best work of their careers. Work that has an impact on individuals...