Business Analyst with Medicare and Medicaid Experience
Location - 3 Penn Plaza- Newark- New Jersey 07105 local is preferred 1 day office per week Visa- any Rate - $55/hr on 1099 or $50/hr on W2
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.
