Business Analyst with medicare

2 days ago


Newark, United States Georgia IT Inc Full time

Job Title - 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.

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