Business Analyst - Medicaid
You will support the Medicaid Management Information System (MMIS) through requirements analysis and testing.
Responsibilities
- Review requirements documentation to ensure accuracy for the intended MMIS solution.
- Develop system change requests and document defects in quality assurance testing tools.
- Develop and execute test cases and scripts for user acceptance testing.
- Participate in project team meetings and prepare weekly status reports.
Required Skills
- 5 years of experience as a Business Analyst.
- Bachelor’s Degree in Computer Science, Computer Engineering, Information Technology, or equivalent workplace experience.
- Experience with HIPAA X12 transactions (837I, 837P, 837D, 835, 276, 277, 270, 271, 834, 820).
- Proficiency in developing SQL queries for analytical purposes.
- Experience with SQL Server or Oracle SQL.
- Experience with at least one programming or scripting language such as Java or SQL.
- Experience with healthcare medical claims processing, including adjudication, submission, and editing.
- Knowledge of billing procedural and diagnosis coding, including HCPCS and ICD-10.
- Experience with Medicaid member eligibility, benefit plan rules, and managed care enrollment.
- Proficiency in Microsoft Office tools including Word, Excel, and PowerPoint.
- Strong written and spoken English communication skills.
Preferred Skills
- Knowledge of Generally Accepted Accounting Principles (GAAP).
- Experience with Federal Financial Participation (FFP) rules and federal reporting.
- Experience with pharmacy billing code standards (NCPDP) and NCPDP electronic claim transactions.
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