Business Analyst

2 weeks ago

noida, India HONCHOSHUNTERS Full time

Key Responsibilities:

- Analyze Medicaid fee schedule requirements for various healthcare services across different states.

- Design and develop fee schedule configurations in collaboration with stakeholders, including Medicaid program managers, actuaries, and IT professionals.

- Implement and maintain fee schedules within the organization's claims processing system.

- Conduct thorough testing and validation of fee schedule implementations to ensure accuracy and compliance.

- Monitor fee schedule changes and updates from regulatory agencies and proactively address any impacts on existing configurations.

- Provide subject matter expertise on fee schedule-related inquiries and issues and collaborate with internal teams to resolve them in a timely manner.

- Document fee schedule specifications, processes, and workflows, and provide training and support to end-users as needed.

Qualifications:

- Bachelor's degree in healthcare administration, Business Administration, Information Systems, or a related field.

- Minimum of (6) years of experience as a Business Systems Analyst, in the healthcare industry and specifically with Medicaid fee schedules.

- In-depth knowledge of Medicaid programs, fee schedules, reimbursement methodologies, and state-specific regulations.

- Proficiency in analyzing complex data sets and translating business requirements into technical specifications.

- Strong analytical, problem-solving, and decision-making skills.

- Excellent communication and interpersonal skills, with the ability to collaborate effectively with cross-functional teams.

- Experience with healthcare claims processing systems and software applications is preferred.

- Certification in Business Analysis (e.g., CBAP) or related field is a plus.

(ref:hirist.tech)

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