United States · Remote OK
Rising Medical Solutions is a medical cost containment company focused on medical bill review, claims support, care coordination, and related solutions that help reduce unnecessary costs and improve outcomes. Our work ce…
Skills: Business Analysis, Prototyping, SQL, Visio, Workflow Diagramming
Milwaukee, Wisconsin, United States · Remote OK
The Strategic Bill Review Analyst will maximize savings for clients by accurately analyzing and processing large medical bills according to appropriate coding review, medical necessity determination, state laws and fee s…
Skills: Medical Bill Review, Medical Coding, Medical Necessity Determination, CPT Codes, Fee Schedule Analysis
Sign up with Clera and we'll reach out the moment a role actually fits you — no more spraying applications into the void.
The Business Analyst II will gather requirements and analyze data to create intuitive, user-focused solutions and detailed visual models. They will collaborate with development and QA teams to ensure requirements are implemented and identify opportunities for business process improvement.
Candidates need 3+ years of business analysis and prototyping experience, along with a bachelor's degree in an IT-related field. Proficiency in SQL, Visio, and UX best practices is required, with healthcare or workers compensation experience being a plus.
Rising Medical Solutions is a medical cost containment company focused on medical bill review, claims support, care coordination, and related solutions that help reduce unnecessary costs and improve outcomes. Our work centers on helping clients navigate complexity more effectively while creating better experiences and stronger results across the healthcare journey.
As a Business Analyst II, you will help turn complex business problems into intuitive, user-focused solutions. This role is well suited to someone who is naturally curious, asks thoughtful questions, uses data to inform decisions, and enjoys partnering across teams to improve how products, processes, and customer experiences come together.
ResponsibilitiesPlease emphasize the following experience:
"We make lives better."
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.
Offices: 325 N LaSalle Street, Suite 600, Chicago, IL 60654, US · 700 West Virginia Street, Milwaukee, WI 53204, US
"We make lives better."
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.
Offices: 325 N LaSalle Street, Suite 600, Chicago, IL 60654, US · 700 West Virginia Street, Milwaukee, WI 53204, US
