Technical Business Analyst with Medicaid & Claims Module experience - Remote

The Dignify Solutions, LLC

Job Title

10-12 years of experience as a Business Analyst with minimum of 8+ years of experience in health care experience especially in MMIS domain.

In depth understanding of Claims and Claims lifecycle:

Claim submission – Paper and EDI X12

Adjudication

Payment Cycle (Finance)

Reporting

Encounters and Capitation

EDI X12 formats like 837P/I/D

X12 formats 835, 834, 270/271, 276/277

Familiarity with systems like CMdS, GHS, Facets and etc

Ability to validate Test scenarios and test plans, test data.

SQL: To validate data in backend tables (e.g., claim status, payment details, find members/providers, Benefit Plan).

EDI Tools: Validating X12 files.

Apply

Vacancy posted 2 days ago

Similar jobs that could be interesting for youBased on the Technical Business Analyst with Medicaid & Claims Module experience - Remote in United States vacancy

Technical Business Analyst with Medicaid Experience - 100% Remote
...receivables. Assess client AR business operations and configure... ...business processes Experience in Provider Recoupment in... ...payable. Discuss with client to understand their... ...maintenance of commercial payer claims solution and/or Medicare/Medicaid system Must have good...
Remote work
Claims
For contractors
The Dignify Solutions, LLC
United States
2 days ago
Senior Business Analyst with Medicaid/MMIS SME Remote
...Medicaid/MMIS Subject Matter Expert... ...SME across claims, eligibility... ...provider modules Lead requirements... ...gathering, business process... ...functional and technical requirements... ...Collaborate with stakeholders... ...business analysts and contribute... ...12 years of experience in Medicaid...
Remote work
Claims
The Dignify Solutions, LLC
United States
1 day ago
Technical Business Analyst
...understanding of the healthcare payer space with a minimum experience of 10 years in the domain.... ...maintenance of commercial payer claims solution and/or Medicare/Medicaid system Must have good... ...various interfaces and include business rules, transformation and DB mapping...
Remote work
Claims
The Dignify Solutions LLC
United States
1 day ago
Principal Technical Analyst - MMIS - Medicaid Pharmacy
$108.5k - $155k
...add to your technical credentials... ...Technical Analyst - MMIS - Medicaid Pharmacy at... ...your passion with purpose,... ...Provider, Claims (Medical, Dental... ...with Business Analysts (BAs... ...and cross‑module dependencies... ...equivalent experience). * 12+ years... ...* Fully remote options from...
Remote work
Claims
Full time
Flexible hours
Gainwell Technologies LLC
Ohio
5 hours ago
Remote Business Analyst - BPA & Medicaid
...technology solutions company is seeking a Business Analyst to support Benefit Plan Administration... ...will have over 3 years of relevant experience, including claims and Medicaid expertise. This role includes opportunities for remote work and focuses on improving healthcare...
Remote work
Claims
Flexible hours
Gainwell Technologies
Madison, WI
5 days ago
Business Analyst with Medicaid/ Medicare/ MMIS Expertise - 100% Remote
...health care domain experience and should have good knowledge of Medicaid and Medicare.... ...-on experience on claims processing and adjudication... ...work closely with the client and development... ...Facets and etc Technical Skills: SQL: To... ...of Clients and Business Units. Ability...
Remote work
Claims
The Dignify Solutions, LLC
United States
8 hours ago
Sr. Business Analyst (Claims Experience Required) - REMOTE
$52.18k - $107.1k
...includes coordination with stakeholders and subject... ...leaders within the business to provide recommendations... ...independently in a remote environment.Ability to... ...Qualifications At least 4 years of experience in previous roles in a... ...for Medicare & Medicaid Services (CMS) and the...
Remote work
Claims
Work experience placement
Work at office
Molina Healthcare
Des Moines, IA
5 days ago
Functional Analyst (Medicaid Investigation)
$97.97k - $124.2k
...Functional Analyst - Principle... ...Medicare and Medicaid Services (CMS... ...completion of technical tasks... ...Analyzes claims data and reviews... ...solutions to business challenges of... ...optimize customer experiences,... ...Assists with identifying... ...while working remotely Required...
Remote work
Claims
Temporary work
Flexible hours
General Dynamics
United States
1 day ago
Medicaid SME Business Analyst - Remote
$91.7k - $163.7k
...The work you do with our team will directly... .... The Medicaid SME Business Analyst plays a pivotal... ...expertise across claims, recipient (... ...flexibility to work remotely * from anywhere... ...Collaborate with technical teams to guide... ...~5+ years of experience working with Medicaid...
Remote work
Claims
Minimum wage
Full time
Work experience placement
Work at office
Local area
Optum
Eden Prairie, MN
4 days ago
Medicaid Business Systems Analyst
...Austin based firm with over 34 years of experience delivering top-tier technical and business professionals within... ...an experience Medicaid Business Systems Analyst to play a key role... ...job: Hybrid, 3 days remote with 2 days (Mon &... ...with Medicaid Claims Processing 5 Required...
Remote work
Claims
Contract work
Local area
Immediate start
Flexible hours
Allied Consultants (Texas)
Austin, TX
14 hours ago
Technical Business Analyst with P&C insurance
...Technical Business Analyst with P&C insurance Remote Highly skilled and experienced Technical Business Analyst... ...Excess PAS projects. Extensive experience in Group Accident Insurance Plans... ...policy lifecycle, underwriting, claims, and compliance. • Exceptional...
Remote work
Claims
Futran Tech Solutions Pvt. Ltd.
United States
4 days ago
Technical EDI Business Analyst_ Remote
...replying to this email with updated resume and convenient... ...3Tech.com Title: Technical EDI Business Analyst Location : REMOTE Duration : 3... ...: 3+ years of Experience working with Open-... ...EDI Transactions (837 - Claims \ Encounters, 834 - Enrolment...
Remote work
Claims
My3Tech Inc
United States
5 days ago
Advisor Business Analyst - MMIS / Medicaid Pharmacy
$86.8k - $124k
Advisor Business Analyst - MMIS / Medicaid Pharmacy Location: Any city... ...your passion with purpose, teaming... ...business, policy, and technical execution across... ..., Provider, Claims (Medicaid,... ...years of hands‑on experience supporting healthcare... ...role Fully remote options from Contiguous...
Remote work
Claims
Full time
Flexible hours
Gainwell Technologies
Washington DC
3 days ago
Technical Business Analyst
...Technical Business Analyst The Technical Business Analyst (TBA) will... ...of health care claims. The TBA plays a crucial... ...position is eligible for remote work, but quarterly... ...stories, working with Product Owner and others... ...position in health care IT Experience as a Technical...
Remote work
Claims
Work at office
Avalon Healthcare Solutions
Tampa, FL
1 day ago
Technical Business Analyst (Development Background)
...well ! Position - Technical Business Analyst (Development... ...Location - 100% Remote Cuboid is looking... ...enterprise and project experience Nice to haves:... ...Healthcare (benefits/claims specifically) Role... ...Project: Will partner with team in a number of ways...
Remote work
Claims
Contract work
H1b
Cuboid IT Solutions
Santa Fe, TX
5 days ago
Technical Business Analyst - API Integration
...expert-level traditional business analyst skills but are also... ...to have proficiency in technical disciplines within... ...expected to work closely with various customers including... ..., or equivalent work experience ~5+ years of... ...underwriting, and real estate to claims, loss control and risk...
Remote work
Claims
Work experience placement
Immediate start
H.W. Kaufman Group
United States
2 days ago
Technical Business Analyst
$43.46 - $45.19 per hour
...Financial Analyst - Fully Remote Join our dynamic Finance... ...collaborating with cross-functional teams to define technical requirements, contribute... ...and aligned with business objectives.... ...analysis. Experience with Power BI and... ...entries, premiums, claims, and billing....
Remote work
Claims
Contract work
Temporary work
Aston Carter
United States
5 days ago
Senior Technical Business Analyst: CPS
$80.55k - $115k
...Software Development Analyst At Jack... ...unions connect with the people they... ...human centered experiences. We deliver... ...requirements definition, technical design,... .... This is a remote position and candidates... .... Prepares business requirements... ...discrimination claim, or cooperating...
Remote work
Claims
Work at office
Local area
Jack Henry and Associates
Monett, MO
4 days ago
Technical Business Analyst
$33.65 per hour
...JOB TITLE: Technical Business Analyst DEPARTMENT: Technology / Business Applications... ..., LLC, a holding company with subsidiaries engaged in... ...broking, programs, and claims services. Venbrook's team of... ...ABILITIES: ~2+ years of experience in a Business Analyst, Data...
Remote work
Claims
Hourly pay
Temporary work
Fixed term contract
Shift work
Venbrook
United States
2 days ago
Senior Java Developer with Medicaid/ Medicare Claims Experience - 100% Remote
10+ years of working experience as a Java developer Candidate should... ...should have good knowledge of Medicaid and Medicare. Candidate... ...have hands-on experience on claims processing and Adjudication processes. Experience with user interface design. Knowledge...
Remote work
Claims
Work experience placement
The Dignify Solutions LLC
United States
8 days ago
Business Analyst with P&C Insurance Experience - Hybrid (Multiple Locations)
...NY; Topeka, KS ~10+ years of experience with Min 7+ years of business analysis experience, with 3+ years... ...of Property and Casualty Insurance Claims. Experience with iterative and... ...detailed business requirements and technical specifications. ~ Proven hands-...
Remote work
Claims
The Dignify Solutions LLC
United States
5 days ago
Technical Business Analyst
...credit unions connect with the people they... ...human centered experiences. We deliver cutting... ...self-discipline in a remote environment, and a... ...responsible for: Technical Product... ...context from existing business requirements and technical... ...discrimination claim, or cooperating in...
Remote work
Claims
Work experience placement
H1b
Local area
Jack Henry & Associates, Inc.
California, MO
1 day ago
Business Analyst - Majesco modules
...Business Analyst for Majesco Modules Role – Remote (travel as needed to client location - IL) Duties and Responsibilities Working with customers to define configuration requirements, and developing... ...systems/Billing/Claims. Estimation. Reviewing end to...
Remote work
Claims
Georgia IT Inc
United States
1 day ago
TriZetto Facets Configuration Analyst with Dental module experience
...TriZetto Facets Configuration Analyst with Dental module experience Location: Remote Duration : 6 + months... ...network and out-of-network dental claims with greater accuracy.... ...Configuration - Dental Technical Skills: Proficiency with data...
Remote work
Claims
Local area
E-Solutions
San Jose, CA
2 days ago
Business Analyst Optum Experience is a plus
...Role: Business Analyst Duration: 7 months Remote Work Job Description: Business Analyst... ...(Part A, B and/or DME), Claims, Finance, Beneficiary, Provider... ...back-up to PO) Assist with creation and maintenance... ...and Visio proficiency Experience gathering and documenting...
Remote work
Claims
Vytwo
Prosper, TX
1 day ago
Technical Business Analyst ( Data Catalog Experience)
...Technical Business Analyst (Data Catalog Experience) Seeking a Technical Business Analyst with strong knowledge of healthcare insurance data products, data cataloging, and data... ...understanding of healthcare insurance data domains (Claims, Member, Provider, Enrollment, Billing/...
Remote work
Work experience placement
Epsilon Solutions Ltd
United States
2 days ago
Business Analyst with P&C experience - Hybrid
...~7+ years of experience in Property & Casualty Insurance for US Insurance carriers.... ...Good understanding of policy lifecycle, claims processing, and billing workflows ~ Experience... ...enhancement programsHands-on experience with Guidewire (PolicyCenter/ClaimCenter/BillingCenter...
Remote work
Claims
The Dignify Solutions LLC
United States
4 days ago
Senior Java Developer with Medicaid/ Medicare Claims Experience - 100% Remote
...needs to determine technical requirements. Consults with end user to prototype... ...design and stated business requirements.... ...+ years of working experience as a Java developer... ...good knowledge of Medicaid and Medicare. ~ Candidate... ...-on experience on claims processing and...
Remote work
Claims
Work experience placement
The Dignify Solutions, LLC
United States
1 day ago
Specialist, Appeals & Grievances (Member Medicaid/Marketplace experience)
...Provides support for claims activities including reviewing... ...in accordance with the standards and requirements... ...for Medicare and Medicaid Services (CMS).... ...per protocol and other business partners to determine... ...years of managed care experience in a call center, appeals...
Remote work
Claims
Contract work
Work at office
Molina Healthcare
United States
4 days ago
Business Analyst - Consultant
...Title: Business Analyst - Consultant... ...On-site/Remote/Hybrid: Hybrid... ...the State's Medicaid Management Information... ...payor of claims towards a... ...is aligned with MMIS innovation... ...to provide technical solutions to... ...assigned modules and work streams... ...7+ years of experience in...
Remote work
Claims
Work at office
InterSources
United States
2 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Technical Business Analyst with Medicaid & Claims Module experience - Remote. Be the first to apply!