Payment Error Rate Measurement (PERM) Business Analyst (BA)

BerryDunn

85d • $85,000 - $115,000

About The Position

BerryDunn is seeking a Payment Error Rate Measurement (PERM) Business Analyst (BA) to join our Medicaid Practice Group. This position will support client work for a State Health and Human Services (HHS) agency that has requested project management and support services to deliver support and implementation of continued business process redesign services, including Business Process Redesign (BPR) strategy, audit support services, and project management support services. The PERM BA will be focused on implementing cost avoidance measures through supporting the agency with audits, in particular, PERM audits, with an emphasis on Medical Record reviews (MR). In addition, the PERM BA will be responsible for assisting the PERM SME in the research, review, and analysis of various project-related activities and tasks. Your initial focus will be on supporting our Hawai'i client. You will report to and partner with senior management in our Medicaid team, both for client work and career development. With a growth mindset, you will drive your development with the support of a learning and development culture. This position offers flexibility in work location, with the option to work fully onsite or in a hybrid capacity. Given that you may be collaborating with teams across multiple time zones, you will need to manage your schedule effectively to ensure availability for meetings and meet deadlines, while having the freedom to work independently when necessary.

Requirements

• Ability to conduct research and analysis related to Medicaid Claims Systems, Medicaid reporting and/or regulatory changes and their impacts on state audits.
• Strong experience with Microsoft Excel, Word, and PowerPoint.
• Prior experience with supporting a State with a PERM cycle, reviewing medical records, and claims.

Nice To Haves

• Preferred prior experience on PERM audits or a minimum of internal audits related to Medicaid billing.

Responsibilities

• Provide frequent, clear, and consistent communication to the client, team members, vendors, and direct reports.
• Participation in staff and/or team meetings.
• Perform quality review of eligibility determinations and accuracy of Managed Care Organization (MCO) payments.
• Serve as a Subject Matter Expert (SME) and provide guidance during PERM cycle preparation activities.
• Provide SME support throughout the PERM cycle, including Corrective Action Plan (CAP) development.
• Analyze medical records and claims to determine the accuracy and relevance of Medicaid payments.
• Provide additional audit support, as directed by the agency.
• Perform assigned administrative tasks efficiently and effectively, asking questions when instructions are unclear.

Benefits

• Access to benefits that support physical, mental, career, social, and financial well-being.

What This Job Offers

• Number of Employees: 501-1,000 employees