Business Analyst with Medicaid/MMIS (Claims/Finance/Members) experience- Remote
Summary
Analyzes Medicaid claims and finance systems, ensuring accurate processing and compliance with state/federal rules using platforms like Health Enterprise or Facets.
12 years of Business Analysis experience with strong Medicaid MMIS/MES domain expertise. Hands-on experience with Health Enterprise, QNXT, Facets, or similar Medicaid claims platforms. Strong experience in at least 2 of 3 areas: Claims, Member/Eligibility, Finance . Experience with Medicaid claims processing, adjudication, adjustments/voids, encounters, Medicare crossover, remittance, and payment processing . Strong knowledge of Medicaid eligibility, enrollment, aid categories, benefit packages…