Medical Claims Systems Analyst II

2 weeks ago


Detroit, Michigan, United States KYYBA Inc Full time

Position: Systems Analyst II

Company: KYYBA Inc

Role Overview –

This position entails overseeing the implementation of benefit modifications for various significant healthcare payer clients. The incumbent will engage with the claims benefits system to pinpoint and document requirements for system alterations, conduct claims testing, validate system improvements, and facilitate the execution of these changes.

Key Skills and Experience Required –

  • Extensive background in medical and facility claims, with a solid grasp of the billing process, including ICD codes, procedure codes, and diagnosis codes.
  • In-depth understanding of medical claims benefits processing.
  • Comprehensive knowledge of medical, dental, vision, and hearing benefits.

Additional Required Skills/Experience –

  • Exceptional analytical and organizational abilities, with the capacity to manage multiple simultaneous projects.
  • Proficient in creating clear and concise documentation that is accessible to individuals without direct expertise in the subject matter.
  • Proficient in Microsoft Office applications (Word, Excel, Access).
  • Strong interpersonal and collaborative skills, fostering a team-oriented environment.

Preferred Skills/Experience –

  • Experience with NASCO 3270 Mainframe.
  • Familiarity with membership and eligibility processes.
  • Experience in BFM/BFAST benefit configuration, including analysis, testing, documentation, and quality assurance processes.
  • Working knowledge of SharePoint.

Education and Certifications –

  • A Bachelor's Degree in a relevant field is preferred.
  • Medical Billing/Coding certification is preferred.

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