Business Analyst - Healthcare

Gainwell Technologies is dedicated to improving health and well-being through innovative technology solutions. As a Business Analyst - Healthcare, you will work collaboratively with clients and team members to document business needs and translate them into effective solutions within the Medicaid Management Information System (MMIS). This role involves managing client expectations and ensuring timely updates and changes to the system.

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:

• 3+ years as a Business Analyst with healthcare claims experience required
• Proficiency in CPT, HCPCS, and ICD-10 coding
• Ability to work collaboratively in a team environment, including making updates to reference systems for coding (CPT, HCPCS, ICD-10) and benefit plan coverage
• Strong Excel skills
• Excellent verbal and written communication skills with the ability to build strong working relationships
• Ability to create and maintain manual documentation and support provider notifications
• A Certified coder is preferred