Business Analyst - Healthcare

Gainwell Technologies LLC•Any city, OH

3d•$55,600 - $79,400•Remote

About The Position

As a Business Analyst - Healthcare at Gainwell, 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 community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Works collaboratively with the client and team members-both external and internal to the company - to research, validate and document business needs, and to ensure that those needs are clearly reflected and completed. Assists with translating client requests and changes into the Medicaid Management Information System (MMIS) and may help determine solutions to business problems. Effectively manages client’s expectations.

Requirements

3+ years as a Business Analyst with healthcare claims experience required.
Proficiency in CPT, HCPCS, and ICD-10 coding
Ability to work collaboratively in a team environment, including making updates to reference systems for coding (CPT, HCPCS, ICD-10) and benefit plan coverage
Strong Excel skills
Excellent verbal and written communication skills with the ability to build strong working relationships
Ability to create and maintain manual documentation and support provider notifications

Nice To Haves

A Certified coder is preferred

Responsibilities

Ensure that items are prepared for client meetings.
Ensure Operating Procedure Manuals are updated as required
Work with the client on change requests, publications and claim adjustments/reprocessing
Research, identify, and specify solutions to problems.
Document updates for all reference updates/changes.
Work with the systems team on any assigned system changes, meeting required timelines
Assist with quarterly and annual CPT, HCPCS and diagnosis code updates in the system, ensuring rules are correct and working on edit and audit configuration.