Senior Business Analyst - Healthcare Claims - MMIS

Gainwell Technologies LLC

3d•Remote

About The Position

As a Senior Business Analyst - Healthcare Claims - MMIS 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.

Requirements

5+ years as a Business Analyst with healthcare claims experience required
Must be proficient in Excel
Proficient in CPT, HCPCS and ICD-10 coding
Must work collaboratively in a team environment in making changes to the reference system for CPT, HCPCS and ICD-10 coding updates and benefit plan coverage.
Build relationships and working collaboratively; effective verbal/ written communication.
Ability to assist/create manual documentation as well as provider notifications

Nice To Haves

Certified coder is a plus

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.