| Configuration Business Analyst Remote need local to OH USC GC only at Remote, Remote, USA |
| Email: [email protected] |
| From: shaik, Convextech [email protected] Reply to: [email protected] Position Title: Configuration Business Analyst Location: Remote (Resource needs to be local from OH) Expected Duration: 18+ Months with the possibility of extension. Visa acceptance: US Citizen/ Green Card Client name (To prevent the dual submission): Gainwell Technologies Type of engagement CTC, CTH, or FT: CTH Job Description: Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Client carries its rewards. Youll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. Youll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities. 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. Summary: As a Configuration Business Analyst at Client, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve a communitys most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcares biggest challenges. Your role in our mission: Analyze provider contracts/ pricing, designs/configure provider agreements, configuration validation, and 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. Configure new and revised claims adjudication logic within a healthcare claims system. Configure products/ benefits, provider agreements, fee schedules, and claims payment rules. Configure Claim Adjustment Reason Codes and Remittance Advice Codes. Quality assurance and testing within the health plan configuration system (e.g., Facets) to ensure the configuration is ready for implementation. Collaborate with the 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. Analyse provider pricing. What we're looking for (top 5 only): 9+ years of configuration experience working in claims configuration. 9+ years of experience identifying patterns within quantitative data, drawing conclusions, and recommending solutions and approaches, skilled with end-to-end issue resolution. 9+ years of experience in health care with emphasis on coding, financial rate setup, 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. Recommended Additional Skills/ Experience: Advanced 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 without supervision. Ability to manage multiple assignments while maintaining quality standards and meeting assigned deadlines. Experience leading teams of 5 or more. Keywords: Ohio |
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| Thu Nov 02 04:51:00 UTC 2023 |