Business Systems Analyst - QNXT Claims

  • Molina Healthcare
  • Columbus, Ohio
  • Full Time


**Job Summary**

A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ability to work independently, self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses of action for remediation. This role will support processes for Patient Liability and Medicaid processes.

**KEY RESPONSIBILITIES**

Perform research and analysis for inquiries and requests, utilizing technical tools as necessary to provide feedback and resolution within the Service Level Agreement.

Assist with research, development and completion of special projects as requested by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations.

Responsible for timely completion of projects, not limited to timeline development and maintenance; coordinates activities and data collection with internal departments or external requestors.

Interpret business needs and translate them into application and operational requirements.

Create comprehensive workflows and documentation of operational processes and procedures.

Prioritize initiatives based on business needs and requirements.

Undertake project tasks as required

**KNOWLEDGE, SKILLS & ABILITIES**

Advanced written, oral, and interpersonal skills

Demonstrated ability of evaluating the effectiveness and efficiency of existing processes

Able to effectively prioritize and execute tasks

Able to generate insights from data analysis

Able to learn quickly and solve complex problems

Experience in partnering with cross-functional teams

Experience with documentation and meeting facilitation

Flexible and able to work with tight deadlines

Knowledge of Healthcare industry standards, concepts, terminology and common practices

Claims and SQL knowledge a plus

**JOB QUALIFICATIONS**

**Required Education**

Associate degree or equivalent combination of education and experience

**Required Experience**

1-3 Years

**Preferred Education**

Bachelor's Degree or equivalent combination of education and experience

**Preferred Experience**

3-4 Years

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $77,969 - $141,371 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Job ID: 487462840
Originally Posted on: 7/31/2025

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