Bill Review Systems Analyst in Tampa, Florida at Paradigm

Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track record of generating the very best outcomes for patients, payers, and providers. Deep clinical expertise is the foundation for every part of Paradigm’s business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs.

We’re proud to be recognized—again! For the fourth year in a row, we’ve been certified by Great Place to Work®, and for the third consecutive year, we’ve earned a spot on Fortune's Best Workplaces in Health Care™ list. These honors reflect our unwavering commitment to fostering a positive, inclusive, and employee-centric culture where people thrive.

Watch this short video for a brief introduction to Paradigm.

We are seeking a full-time, remote Bill Review Systems Analyst. The Bill Review Systems Analyst is responsible for analyzing Bill Review operational processes to identify and implement changes to improve performance on key performance indicators including productivity, reliability, quality, and efficiency.

The schedule for this position is Monday - Friday, 8 AM to 5 PM Central Time. This position may require travel 1-2 times per year.

Responsibilities include (but are not limited to):

• Serve as system configuration subject matter expert: understand, document, and be able to explain how the bill review system applies rules and settings to process bills.
• Work closely with Bill Review leaders to implement any changes to bill review processes including editing of rules and configuration / reconfiguration of systems
• Perform data gathering, root cause analysis and performance trending in order to develop appropriate process control changes
• Prepare communication plans regarding process re-engineering for multiple stakeholders
• Inform respective teams on process improvement and re-engineering strategies
• Coordinate internal compliance auditing, monitoring and review activities in conjunction with the Clinical Bill Review department
• Provide testing and system support in relation to data reporting processes and requirements
• Update and maintain documentation on system configuration as changes are implemented
• Assist Project Managers and Program Managers in strategic projects and key initiatives
• Identify and resolve Company, State/NCCI Reporting, and/or client data issues, including with vendors as applicable

Requirements:

• Bachelor's Degree in appropriate field of study or equivalent work experience
• 5+ years’ experience in process/systems analysis, engineering, and/or process improvement including executing at least two major process creations or transformations
• 5+ year’s experience generating and analyzing reports to monitor productivity, throughput, and/or other operational KPIs
• Proven working experience in project and change management
• Excellent client-facing and internal communication skills
• Excellent written and verbal communication skills
• Solid organizational skills including attention to detail and multitasking skills
• Strong working knowledge of Microsoft Office and Visio
• 3+ Years’ experience working in bill/claims processing systems in the Workers Compensation industry across multiple jurisdictions.