Job Details

Claims Business Analyst

Onsite at SFO CA

12 Months Contract

Looking for 10 plus years of overall experience

• 5+years Medicare/Medicaid regulatory healthcare experience.
• 5+ Years experience in IQVIA Claims, DDD sales, 867, and 852 inventory, marketing and calls datasets.
• Proficiency in Agile Project Management (Jira or ADO Board) is essential, and experience with AWS Cloud is preferred
• Knowledge of claim adjudication processes and Facets platform experience preferred
• Experience transforming complex technical requirements into an easily understood summary
• Analytical skills including critical thinking and problem solving
• Clear and concise verbal and written communication skills
• PC proficiency to include Microsoft Word, Excel, and Outlook
• Organizational skills including attention to detail and multi-tasking skills
• Experience working both independently and in a team environment
• Experience with Mass Health governing policies and procedures and procedural knowledge of the CMR and Bulletin releases and forums
• Behavioural Health requirement understanding in both Medicare, dual and Mass Medicaid required