| Business Analyst REMOTE US Citizen or GC only at Remote, Remote, USA |
| Email: [email protected] |
| From: shaik, Convextech [email protected] Reply to: [email protected] Position Title: Business Analyst Location: Remote Expected Duration: 6+ Months with a Strong possibility of Extension Job Type: 40/hr Week/ Contract/Remote Pay Range: $40/hr C2C/1099 Visa- GC,USC only Description: In this role you will design, build, and validate the Medicaid Information Technology System (MITS) across functional areas. You will support complex system configuration changes and new configuration requirements, including configuration analysis, design, build and testing. Duties include troubleshooting and fixing system configuration errors, performing investigations and root cause analysis of trouble tickets, and ensuring day to day issues are identified and appropriately addressed. Primary Responsibilities: Configuration Design Analyzes provider contracts / pricing, designs / configures provider agreements, configuration validation, configuration peer review Communicate design to all stakeholders and varying levels of the organization Present and evaluate design solutions objectively and facilitate conflict resolution Define, use, and communicate design patterns and best practices in service-oriented analysis, design, and development Configuration Build & Maintenance Configuration of new and revised claims adjudication logic within a healthcare claims system Configuration of products / benefits, providers agreements, fee schedules, and claims payment rules Configuration of Claim Adjustment Reason Codes and Remittance Advice Code Provider (Contract and Pricing) Configuration Configuration Quality Assurance Quality assurance and testing within health plan configuration system (e.g., Facets) to ensure configuration is ready for implementation Collaborate with quality assurance team to ensure testing efforts align with system deliveries and business processes Develop strategies to improve service development life cycle and governance processes Develop and use enterprise service and data models Quality assurance and testing Provider Pricing Analysis knowledge Requirements: To be considered for this position, applicants need to meet the qualifications listed in this posting. Required Qualifications: 4+ years configuration experience working in claims configuration 4+ years of experience identifying patterns within quantitative data, drawing conclusions, and recommending solutions and approaches, skilled with end-to-end issue resolution 4+ years of experience in health care with emphasis in coding, financial rate set up or claims processing in a managed care environment. Must be knowledgeable of medical claims data, formats and restrictions including but not limited to Revenue Codes, Place of Service codes, ICD-10 codes, CPT Codes, and Modifiers. Experience in Medicaid or Medicare environments. Intermediate or greater level of proficiency with Microsoft Excel and Word Excellent oral and written communication skills, interpersonal skills and organizational abilities are essential Ability to work effectively with minor supervision Ability to manage multiple assignments while maintaining quality standards and meeting assigned deadlines Preferred Qualifications: Bachelors Degree in Business Administration or related area preferred 2+ years experience writing and executing SQL/SQL Scripts Keywords: green card |
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| Tue Oct 03 02:07:00 UTC 2023 |