Senior Business Analyst - Managed Care Entity
About The Position
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 Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll 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. SummaryAs a Senior Business Analyst - Managed Care Entity 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. In this position you will work 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. You will assist with translating client requests and changes into the MMIS and may help determine solutions to business problems. While effectively managing client’s expectations.Your role in our missionPlay a critical part in ensuring Gainwell is meeting our clients’ objectives in important areas.
Requirements
- 5+ years of Healthcare Claims experience
- Good understanding of CPT, HCPCS and ICD-10 coding
- Hands - on experience with Encounter Claims (shadow billing), required to track and follow EC mailbox.
- Must be proficient in Excel
- Must work collaboratively in a team environment.
- Build relationships and working collaboratively internally and externally
- Effective verbal/ written communication.
- Ability to assist/create manual documentation as well as provider notifications
- Fully remote options from continental US locations only
- Video cameras must be used during all interviews, as well as during the initial week of orientation
Nice To Haves
- Certified coder is a plus
Responsibilities
- Ensure that items are prepared for client/MCE meetings.
- Ensure Operating Procedure Manuals are updated as required
- Work with the client on claims research. change requests, and suspended claims
- Research, identify, and specify solutions to problems.
- Document creation and updates for projects.
- Assist with Managed Care Entity encounter meetings, questions and research
Benefits
- generous, flexible vacation policy
- educational assistance
- leadership and technical development academies
- 401(k) employer match
- comprehensive health benefits
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
