Business Analyst with medicare - Newark,NJ

Business Analyst With Medicare

Location: Newark, NJ

Duration: Contract

Rate: DOE

Work Authorization: USC, GC, GC-EAD, H4EAD, TN, L2EAD

Job Description

This position is responsible for the ability to understand and abide by Federal Centers for Medicare and Medicaid Services guidance.

Skillset:

• 6-8 years of experience in Medicare for Healthcare Payer Industry
• Excellent understanding of Quality Process, Performance and HEDIS measures
• Working within comprehensive understanding of several databases
• Ability to create, write, Query SQL programs, generate and investigate data.
• Hands on exposure in working with SaaS platform
• Maintain timely and appropriate communications with internal and external stakeholders
• Control Inventory
• Identification and communication of processing performance opportunities

Responsible for performing below services under Medicare STARS Initiative:

• Reconciling daily, weekly and monthly Medicare reports generated from CMS as well as researching when required
• Deadline sensitive information processing, including Quality Audit.
• Processing information accurately and timely
• Reviewing and Analyzing reports to identify daily/weekly priorities set by business team
• Working within a comprehensive understanding of several databases
• Generating and ensuring compliance and accuracy of various type of member correspondence
• Reconciling eligibility discrepancies relying on your ability to arrive at a consistently compliant disposition after the analysis of information from several reference-guidance, Call Center notes, multiple databases, and telephone outreach.