Business Analyst - Medicaid Claims

Gainwell Technologies LLC

1d•Remote

About The Position

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. SummaryAs a Business Analyst - Medicaid Claims 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. Here are the details on this position. You will support the Claims and Reference functional areas of the Arkansas Title XIX fiscal agent account. This position will be assigned to coordinate the system modifications and enhancements related to Claims/Reference/Business Processing Application (BPA). A knowledge of procedure codes, diagnosis codes, benefit plans, and rules engine functionality are a plus. Here are the details on this position.Your role in our missionTake charge and focus on how we can meet critical needs to help clients deliver better health and human services outcomes.

Requirements

3 or more years of experience working as a business analyst between technical and non-technical personnel, with Medicaid and Medicare experience preferred.
Experienced in claims processing with a strong focus on policy-driven outcomes and compliance with regulatory standards. Experience and knowledge with HCPCS and ICD procedure codes and ICD diagnosis code is a plus
Familiarity with HIPAA EDI X12 transaction sets, particularly 837 (Claims)
Knowledge of Microsoft Excel advanced features such as macros and core functions. Experience with relational database software and SQL is a plus
Ability to clearly and concisely translate technical requirements to a non-technical audience
Skills working with business processes and re-engineering
Curiosity to solve complex problems and strong interpersonal skills to interact with and influence clients and team members
A caring team leader who motivates and coaches less experienced resources

Responsibilities

Coordinate workstreams and teams on IT projects to align solutions with client business priorities
Demonstrate your knowledge as SME and liaison for clients and internally between technical and non-technical workers to transform requirements into real results
Delegate work across teams, and coach and monitor project team members to plan, design, and improve complex business processes and modifications
Streamline workflows across clients and technical personnel to determine, document, and oversee carrying out system requirements
Support quality control as you create and execute test cases to verify that all requirements have been met