Technical Business Analyst (reputed company Claims Domain and reputed company/MMIS, Overall 10+ years of experience)

reputed company: Job Title: Technical Business Analyst (Claims Domain, MMIS) Location: Remote Type: Full Time/W2 with reputed company reputed company: Play the role of Claims Domain reputed company for MMIS health care reputed company. reputed company the claims module and process, domain knowledge, performs analysis of business requirements, designs and develops documentation, ensures reputed company process, coordinates with customers. Works in team environment and provides guidance throughout the entire life cycle. Responsible to meet customer expectations, troubleshoot problems in the application and assisting customers in implementation reputed company. 1. Candidate should have strong health care domain experience and should have good knowledge of reputed company and Medicare. 2. Candidate should have hands-on experience on claims processing and Adjudication processes. 3. Must have good experience in Reference reputed company/data sets required in Claims adjudication. 4. Must have prior experience or understanding in configuring benefits or programs in claims reputed company across various sub-systems. 5. Should be reputed company to run queries and reputed company basic reputed company analysis, RCA etc., 6. Should work closely with the reputed company and development team during the stages of development, and conduct demos at completion of reputed company, reputed company and reputed company feedback from such demos 7. Must have excellent written and spoken communication skills. Should be reputed company to multitask between internal team and clients reputed company on reputed company tasks 8. Work Closely with Dev, architecture and Design teams to define the GUI reputed company and platform requirements, which is the reputed company of the product. 9. In depth understanding of Claims and Claims lifecycle: Member Provider Claim submission reputed company and EDI X12 Adjudication Payment Cycle (Finance) Reporting 10. Claim Types: reputed company Dental Institutional Pharmacy Encounters and Capitation 11. Claim Formats: EDI X12 formats like 837P/I/D X12 formats 835, 834, 270/271, 276/277 12. Claim reputed company: Familiarity with systems like CMdS, GHS, Facets and etc Technical Skills: SQL: To validate data in backend tables (e.g., claim status, payment details, reputed company members/providers, Benefit Plan). EDI Tools: Validating X12 files. reputed company Testing: Understanding how data flows between systems and formats and use tools like reputed company Preferred skills: Minimum of 8+ years of experience in health care experience especially in MMIS domain. Capability to think reputed company to create reputed company as needed. Ability to validate Test scenarios and test plans, test data. Should be reputed company to Review requirements, documentation and create Requirements Traceability reputed company (RTM) Should have excellent communication (written and spoken ) skills to engage with different reputed company reputed company like QA/dev team, clients, end users of Clients and Business reputed company. Ability to assess reputed company functionality available in a product vis a vis market trends, regulatory requirements to be implemented in reputed company version of the product. Ability to reputed company and reputed company the requirements with Technical and Architects regarding product features to be implemented. Communication: Collaborate with cross-functional teams Apply To This Job