Senior Professional Business Analyst

Job Description
Sr Professional Business Analyst Configuration
This is a Remote Assignment
Description:
In this role you will design, build, and validate the Medicaid Information Technology System (MITS) across functional areas. You will support complex system configuration changes and new configuration requirements, including configuration analysis, design, build and testing. Duties include troubleshooting and fixing system configuration errors, performing investigations and root cause analysis of trouble tickets, and ensuring day to day issues are identified and appropriately addressed.
Primary Responsibilities:

• Configuration Design
  • nalyzes provider contracts / pricing, designs / configures provider agreements, configuration validation, configuration peer review
  • Communicate design to all stakeholders and varying levels of the organization
  • Present and evaluate design solutions objectively and facilitate conflict resolution
  • Define, use, and communicate design patterns and best practices in service-oriented analysis, design, and development
• Configuration Build & Maintenance
  • Configuration of new and revised claims adjudication logic within a healthcare claims system
  • Configuration of products / benefits, providers agreements, fee schedules, and claims payment rules
  • Configuration of Claim Adjustment Reason Codes and Remittance Advice Code
  • Provider (Contract and Pricing) Configuration
• Configuration Quality Assurance
  • Quality assurance and testing within health plan configuration system (e.g., Facets) to ensure configuration is ready for implementation
  • Collaborate with quality assurance team to ensure testing efforts align with system deliveries and business processes
  • Develop strategies to improve service development life cycle and governance processes
  • Develop and use enterprise service and data models Quality assurance and testing
• Provider Pricing Analysis knowledge

Required Qualifications:

• 6+ years configuration experience working in claims configuration
• 6+ years of experience identifying patterns within quantitative data, drawing conclusions, and recommending solutions and approaches, skilled with end-to-end issue resolution
• 6+ years of experience in health care with emphasis in coding, financial rate set up or claims processing in a managed care environment.
• Must be knowledgeable of medical claims data, formats and restrictions including but not limited to Revenue Codes, Place of Service codes, ICD-10 codes, CPT Codes, and Modifiers.
• Experience in Medicaid or Medicare environments.
• dvanced or greater level of proficiency with Microsoft Excel and Word
• Excellent oral and written communication skills, interpersonal skills and organizational abilities are essential
• bility to work effectively without supervision
• bility to manage multiple assignments while maintaining quality standards and meeting assigned deadlines

Preferred Qualifications:

• Bachelor's Degree in Business Administration or related area preferred
• 4+ years' experience writing and executing SQL/SQL Scripts

About Diversified Systems
Founded in 1990, Diversified Systems is an award-winning Technology Services corporation providing all levels of IT project consulting services nationwide. DSI is headquartered in Columbus, Ohio with regional offices in the American Midwest and East Coast. We offer our consultants a number of flexible and competitive compensation benefit packages.
Diversified Systems is committed to the principles of equal employment. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations.
Diversity, Equity and Inclusion
DSI values authenticity and is committed to making sure our employees and partners are valued and respected. At DSI, we believe building a diverse culture is important because we know when people work together, we can achieve better results as a team. DSI realizes that everyone comes from various backgrounds. We celebrate these differences because our employees are our greatest asset as we strive to best meet the needs of those we serve. As part of our ongoing efforts, DSI is focused on advancing equality, diversity, and inclusivity by setting high standards to continually evolve our culture. This includes but is not limited to recruiting, community involvement, client delivery, and career development.