Senior Business Analyst - Managed Care Entity

Gainwell Technologies is a company dedicated to improving the health and well-being of vulnerable communities through innovative technology. As a Senior Business Analyst - Managed Care Entity, you will work collaboratively with clients and team members to document business needs and translate client requests into actionable solutions, ensuring that client objectives are met effectively.

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

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
• Certified coder is a plus