Medicaid Business Analyst

Medicaid Business Analyst

21 Jul 2024
North Carolina, Raleigh / durham / CH, 27612 Raleigh / durham / CH USA

Medicaid Business Analyst

Vacancy expired!

Hourly Rate: $26 W2; $30 CTC/1099

Job Description:
Position Overview:

This position will serve as a member of the Business Technology Relationship Management team. The unit is responsible for managing relationship between the DHB program/functional areas and the Technology that supports the business and supports all of the division.

Job Specific Responsibilities

Review of various claims reports to perform in-depth claim analysis, validation of system changes, and review of edits/audits in order to make recommendations to maintain the integrity of the reprocessing.
Provide incident monitoring, problem ticket, incident creation and troubleshooting.
Defect Resolution
Requesting System Enhancements


Preferred Knowledge, Skills, and Abilities:

Experience working with NC Medicaid
Experience with NCTracks
Experience with gathering requirements
Experience working with claims adjudication/reprocessing
An understanding of claim edits and audits
Strong understanding of health care strategy, operations, technology, and regulatory requirements
Demonstrated ability to work independently in a fast-paced environment with concurrent deadlines
Excellent communication, negotiation, conflict resolution and persuasion abilities
Strong organizational, time management, communication, and detail-oriented skills
Highly proficient with Microsoft Outlook, Word and Excel

Required Skills:

  • Experience working with NC Medicaid (5 years)
  • Experience with NCTracks (5 years)
  • Experience working with claims adjudication/reprocessing (5 years)
  • Experience with gathering requirements (5 years)
  • An understanding of claim edits and audits (5 years)
  • Strong organizational, time management, communication, and detail-oriented skills (5 years)
  • Excellent communication, negotiation, conflict resolution and persuasion abilities (5 years)
  • Strong understanding of health care strategy, operations, technology, and regulatory requirements (5 years)

Medicaid Business Analyst Medicaid Experience, Gathering Requirements, Claim Edits and Audits

Higher Competitive Rates will be considered for consultants with advanced skill set

Corp to Corp Resumes are welcome

Consultants may need a criminal background check

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