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Gainwell Technologies

Compare

4.1

based on 96 Reviews

3 Gainwell Technologies Business Analyst Jobs

Business Analyst (US Healthcare / Medicaid)

Gainwell Technologies

4.1

based on 96 Reviews

0-3 years

Bangalore / Bengaluru

1 vacancy

Business Analyst (US Healthcare / Medicaid)

Gainwell Technologies

posted 1mon ago

Job Role Insights

Flexible timing

Key skills for the job

Data Analysis Healthcare US Healthcare Claims Adjudication IT Business Analysis System Design

+ 3 more

Job Description

Support the full life cycle of development activities to assist us in delivering new services and technical products to clients

Perform as an advisor and individual contributor for product systems, processes, software configuration, network architecture and interface capabilities
Assist in preparing and addressing product requirements by determining usability and implementing change requests to meet business needs
Deploy specific product configurations and bring your skills to overall system design and integration
Participate in user acceptance testing and coordinate product launches into new and existing markets
Get involved in helping define and outline business cases to ensure that our proposed solutions can deliver significant business benefits to clients

What were looking for

Qualifications

Bachelors degree or equivalent combination of education and experience.
4 or more years of business analysis experience.
Openly and actively communicates information and takes initiative to communicate extensively.
3 or more years experience configuring in QNXT or FACETS:
Contracts/benefits.
System data points needed for successful X12 transactions, Claim Adjustment Reason Codes and Remittance Advice Code.
Contracts for provider services, benefits for member coverage, fee schedules, capitation, and claim editing enforcement.
Understands Medicaid Program structure in carriers, programs, benefit plans, policy, policy plans, sponsor, and or policies.
Understands Provider (Contract and Pricing) data including but not limited to provider type, specialty, taxonomy, enrolment impacts, service locations, certifications and licensing, affiliations, and reimbursement impacts.
Understands Member data including but not limited to aid categories, coverage codes, benefit packages, restrictions, limitations, prior authorizations, programs, and primary care providers.
Experience with Configuration Implementation Build & Maintenance.
Experience working with complex systems at a detailed level.
Experience working in a virtual team environment performing self-directed tasks.
Understands relational database concepts and schemas.
Experience writing SQL queries for data analysis.
Experience working with Medicaid/MMIS systems.
Preferred experience includes DDI (Design, Development, and Implementation) and operations phases.
Experience processing Medicaid claims and ability to troubleshoot adjudication results.
Demonstrated aptitude for learning new technologies and keeping current with industry best practices.
Experience with Requirement Traceability Matrices.
Ability to multi-task and maintain organization in a fast-paced environment.
Ability to create and maintain highest levels of confidentiality when dealing with proprietary or private information.
Ability to exercise sound judgment and make decisions in a manner consistent with the essential job function.
Preferred experience working with HP Application Lifecycle Management (ALM).