ARGO is a leading provider of software and analytics solutions for both the financial services and healthcare industries. ARGO transforms business processes for financial service providers and healthcare organizations using proven business models and software innovation informed by real customer challenges, breakthrough technology, and rich analytics.JOB SUMMARY:
Argo provides behavioral health software that improves reimbursement rates by automating the utilization review process — including chart review for diagnostics, scheduling authorization calls, presenting patient information during calls, maintaining results in the form of business KPIs, and aiding in patient transitions across levels of care (step-up/step-down).
We are expanding our platform to support physical rehabilitation services and seek a Business Analyst who understands the rehabilitation industry’s reimbursement :authorization process. The Business Analyst will gather requirements, define specifications, and support development of utilization review workflow and approval.

QUALIFICATIONS:

• Bachelor’s degree (or graduate degree) in Business, Health Informatics, Rehabilitation Sciences, nursing, therapy, or a related field.
• 3–5+ years of Business Analyst experience in behavioral health, physical rehabilitation, utilization review, or healthcare technology environments. :Alternately, healthcare revenue cycle experience including claims processing or case management- either on the insurance company or healthcare facility side.

REQUIRED SKILLS / EXPERIENCE / KNOWLEDGE:

• Experience in one or more of the following domains:
• Utilization Review or Utilization Management
• Revenue Cycle Management or Billing
• Claims processing
• Case Management
• Behavioral Health (preferred)
• Physical Rehabilitation (required)
• Experience with one or more of the following::
• Physical rehab insurance review and denial processes
• Patient diagnostic code terminology (UMLS)
• EMR systems including therapy documentation for speech, physical :and occupational therapy
• Therapy progress tracking using FIM scores
• Patient discharge planning/ case management
• Working knowledge of HIPAA, 42 CFR Part 2, and healthcare data privacy standards
• Awareness of CARF accreditation standards
• Effective verbal and written communication

PREFERRED SKILLS / EXPERIENCE / KNOWLEDGE:

• Experience with EHR platforms in behavioral health and/or physical rehab (e.g., Netsmart, Qualifacts, Raintree, Epic Rehab)
• General understanding of HL7/FHIR data exchange standards
• Business analysis certification (e.g., CBAP, PMI-PBA)
• Knowledge of Medicaid/Medicare/ private insurance billing and payer-side coordination
• SaaS product development lifecycle experience in a healthcare technology company

DISCLAIMER:

Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

ADDITIONAL REQUIREMENTS:

Applicants for U.S. or Canadian based positions with ARGO must be legally authorized to work in the United States or Canada. Verification of employment eligibility will be required at the time of hire. Visa sponsorship is not available at this time for ARGO positions.
Pre-employment background screening will be conducted

• Collaborate with utilization review and IT teams to identify system and process requirements for behavioral health and physical rehabilitation workflows.
• Analyze and document complex business processes, translating them into clear functional and technical specifications.
• Create user stories, process diagrams, and requirement traceability documents.
• Support product design and development by clarifying requirements and participating in Agile ceremonies.
• Conduct gap analyses for product enhancements and regulatory alignment (HIPAA, 42 CFR Part 2, CARF).
• Participate in and support user acceptance testing (UAT), ensuring delivered functionality meets requirements.
• Contribute to project planning and assist implementation teams with rollout documentation and change management.Produce development status reports