Senior Business Analyst, Claims Module

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $85.5k - $111k / year

⏰ Full Time

🟠 Senior

🧐 Business Analyst

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Conduent

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2017

🤝 B2B

🛍️ eCommerce

🏛️ Government

💰 Venture Round on 2009-01

B2B • eCommerce • Government

Conduent is a leading provider of technology-led solutions aimed at enhancing customer experiences and improving operational efficiency for businesses and government agencies. The company offers a wide range of services, including customer experience management, finance and accounting solutions, human capital management, integrated digital solutions, and specialized services for healthcare and public sector clients. By leveraging automation and analytics, Conduent helps organizations streamline processes and drive business success.

📋 Description

• Play the role of Claims Domain lead for MMIS health care projects • Drive the claims module and process • Perform analysis of business requirements • Design and develop documentation and ensure quality process • Work in a team environment and provide guidance throughout the life cycle • Meet customer expectations and troubleshoot problems in the application • Assist customers in implementation decisions

🎯 Requirements

• Strong health care domain experience • Good knowledge of Medicaid and Medicare • Hands-on experience on claims processing and Adjudication processes • Experience in Reference code/data sets required in Claims adjudication • Understanding in configuring benefits or programs in claims system across various sub-systems • Ability to run queries and perform basic system analysis • Excellent written and spoken communication skills • Ability to multitask between internal team and clients • Close work with Dev, architecture and Design teams • In depth understanding of Claims and Claims lifecycle • Familiarity with systems like CMdS, GHS, Facets • SQL skills to validate data in backend tables • Validating X12 files and understanding data workflows

🏖️ Benefits

• Health insurance coverage • Voluntary dental and vision programs • Life and disability insurance • Retirement savings plan • Paid holidays • Paid time off (PTO) or vacation and/or sick time