Senior Business Analyst - Healthcare Claims - MMIS

Gainwell Technologies is a company that values contributions and promotes career development. As a Senior Business Analyst - Healthcare Claims - MMIS, you will work to improve healthcare outcomes by collaborating with clients to address their claims-related challenges and implementing innovative solutions.

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

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
• Certified coder is a plus