Business Analyst with Medicare

Richmond, VA 23220

Job Category: Information Technology Job Number: 156315

Job Description

Job Title:               Business Analyst with Medicare

Location:               Richmond, Virginia - 23220

Job Type:               Contract

Duration:               6+ months

Job Description:

Essential Job Responsibilities:

  • Healthcare Business Analyst translates business needs into clearly defined and documented detailed, high quality requirements and/or supplemental specifications for new applications or analyzes change requests/enhancements in existing applications.
  • Analyzes data to determine business problems.
  • Handles information including patient services and how the services are paid after conducting investigations and pursuing recoveries through contact with various parties.
  • Works collaboratively within or outside the team to identify charge system weakness, to recommend changes and focused education. 
  • Will also ensure adherence to compliance policies and contracts. Knowledge and experience of Medicare & Medicaid.
  • 7+ years of experience working in an operations role at a health plan
  • 4+ years of Healthcare experience in any of the following:
  • Government Programs,  Core Administer Delivery, Program Management, Product Management, or Network Management
  • 2+ years of experience in one or more of the following:
  • Operational business process improvement, business process analysis, benchmark analysis or workflow analysis
  • Ability to work on claims with different LOBs such as Commercial, Medicare, Medicaid etc.
  • Knowledge and experience of Medicare & Medicaid state level reporting levels
  • Strong Knowledge/Experience with Dimensional Modeling
  • Strong understanding of healthcare data formats, standards, and can map them to CMS and state level reporting needs
  • Good understanding on the lifecycle of claims adjudication
  • Possess good exposure on the various claim functionalities such as Edits, COBs, claims adjustments, Episodes etc.   
  • Preferred.
  • Experience working with Medicare, Medicaid Blues organization(MCO)
  • Understanding of Medicare Part A,B
  • Understanding of handling claims population for Dual eligible populations 
  • Knowledge of Medicare/Medicaid reimbursement methodology(PPS/DRG)

About ASK: ASK Staffing is an award-winning technology and professional services recruiting firm servicing Fortune 500 organizations nationally. With 5 nationwide offices, two global delivery centers, and employees in 42 states-ASK Staffing connects people with amazing opportunities

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Recruiter:         Jeff Kasula


Phone:              (678) 890-5105

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