Business Analyst

Our client provides a wide range of strategy development, business and advisory services, program management, and training services to government and commercial clients.
They are seeking a Business Analyst (100% virtual position).
Perform peer reviews, review any updates done to the requirement or to the ruleset configuration.
Maintain Test data set to perform any internal testing.
Load ruleset to the Business Analyst Environment to Unit test any new Configuration or updates to the existing configuration.
Review/Create New Requirements or Change Requests.
Update existing Requirements.
Review/Create New Business Rules.
Update existing Business Rules and implement any changes to the Rulesets.
Review/Analyze and log defects in JIRA pertaining the files received/processed from MMPs.
Review/Analyze and create any new Test cases.
Update any existing Test case.
Sort and group together test cases from UAT Test case list to different cycles in JIRA.
Execute and analyze the test cases sorted in different cycles in JIRA.
Experience with CMS Encounter Data
3-5 years claims system business analyst experience
Expertise in validating CMS claims against data provided by medical plans;
Experience with processing NCCI , MUE, WEDI Snip editing;
Extensive knowledge of Medicare/Medicaid state-specific claim processing rulesets;
Experience with Analysis and validation of EDI 837, 277 CA transactional processing;
Working experience with interfaces of claims pricing and editing tools;
Working experience with rule-based engines, such as DROOLS; MS Office suite;
SDLC Proficiency;
Experience working with Agile Lifecycle and methodologies;
Excellent communication skills;
Excellent writing skills.
Technical experience with unit testing and validation;
SQL knowledge; Database (Oracle);
General Healthcare domain knowledge;
Knowledge of Medicare benefits;
Experience with JIRA and Confluence.
Bachelors' degree
EOE M/F/Disability/Vet
Our Client will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.
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