Worker's Compensation Bill Review Systems Analyst

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 Worker's Compensation Bill Review Systems Analyst. The Bill Review Process Analyst is responsible for analyzing Bill Review operational processes to identify and implement changes to improve productivity, reliability, quality, and efficiency and serves as the system administrator and subject matter expert. The ideal candidate will have experience implementing system change (rule writing, etc.) on a worker's compensation bill review system (Smart Advisor or similar), analytical skills, and familiarity with state/NCCI reporting. 

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

REQUIRED:

• 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
• 3+ Years’ experience working in bill/claims processing systems in the Workers Compensation industry across multiple jurisdictions.
• 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
• Bachelor's Degree in appropriate field of study or equivalent work experience

Paradigm Benefits:

• Health and wellness– We want our people to be and stay healthy, so we offer PPO, HDHP, and HMO health insurance options with Cigna and Kaiser (CA employees only).
• Financial incentives – Paradigm’s financial benefits help prepare you for the future: competitive salaries, 401(k) matching contributions, employer-paid life and disability insurance, flexible spending and commuter accounts, and employer-matched HSA contributions.
• Vacation - We believe strongly that work-life balance is good for you and for our company. Our paid time off and personal holiday programs give you the flexibility you need to live your life to the fullest.
• Volunteer time– We want our employees to engage with and give back to their communities in meaningful ways.  Full and part-time employees receive one paid day per calendar year.
• Learning and development: One of Paradigm’s core values is expertise, so we encourage our employees to continually learn and grow. We support this in a variety of ways, including our new Learning Excellence at Paradigm (LEAP) program.

Paradigm believes that fostering a diverse and inclusive workplace is central to our mission of helping more people and transforming lives. We’re striving to build a culture that better reflects the society we live in and empowers our team to deliver the highest levels of compassion and care to those we serve. For us, achieving this goal requires a workforce that respectfully embraces differences and commits to positive change, creating an environment where everyone is able to bring their whole self to work.

Paradigm complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Leave Management at leave.management@paradigmcorp.com.  

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

As a contractor with the State of Wisconsin, Paradigm complies with Wisconsin Contract Compliance Law (§16.765). Poster link: Contract Compliance Law Poster

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