Business Analyst III – Medicaid Overpayment Recovery

Role Overview

• Collaborate with internal business partners to gather requirements, lead stakeholder discussions
• Research Medicare and Medicaid reimbursement guidelines
• Request or execute data queries to support recovery initiatives and business decisions
• Drive continuous process improvements by submitting enhancement requests for recovery projects and reporting tools
• Coordinate deliverables across stakeholders
• Ensuring timely completion of project milestones and business objectives
• Analyze complex end user needs to determine optimal means of meeting those needs
• Determine specific business application software requirements to address complex business needs
• Develop project plans and identify and coordinate resources
• Work with programming staff to ensure requirements will be incorporated into system design and testing
• Act as a resource to users of the software to address questions/issues
• May provide direction and guidance to team members and serves as an expert for the team.

Requirements

• Requires a BA/BS and minimum of 5 years business analysis experience; or any combination of education and experience which would provide an equivalent background.
• Healthcare business analysis experience
• Experience in using Excel, Facets and MACESS
• Medical billing and/or claims processing experience is preferred
• 5+ years of experience with data analysis, claims processing, provider billing, FWA investigations, cost containment, Medicare, Medicaid, MMP and/or MedSupp plans
• Medical coding experience
• CPT, HCPCS, ICD-9/10 coding
• CPC or applicable professional designation a plus.

Benefits

• a comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution
• medical, dental, vision, short and long term disability benefits
• Paid Time Off
• merit increases
• paid holidays
• wellness programs
• financial education resources