Business Analyst

Job description

• Analyze and configureAccounts Receivable (AR) processes including provider recoupments, recoveries, and fund management within MMIS
• Configure and supportAccounts Payable (AP) processes including contractor payments, disbursements, and 1099 compliance
• Supportfiscal management functions including budgeting, fund allocation, and financial tracking
• Gather, analyze, and documentbusiness requirements from clients and stakeholders
• Translate business requirements intofunctional specifications, business rules, and system configurations
• Performgap analysis by comparing existing system reports (AR, AP, cash receipts, payments) with client-specific requirements
• Develop and maintainreport specifications for financial modules
• Work closely withdevelopment, QA, and architecture teams to ensure accurate implementation of requirements
• Createinterface mapping documents including business rules, data transformation, and database mappings
• Supportclaims processing systems, including provider, member enrollment, and care management workflows
• Utilize healthcare reference datasets such asCPT, HCPCS, ICD, CDT in claims adjudication
• Participate intesting activities, including validation of test scenarios, test plans, and test data
• SupportUAT cycles, conduct demos, and track feedback for resolution
• Performdata analysis and SQL queries to validate system behavior and troubleshoot issues
• Ensure adherence toSDLC processes, documentation standards, and RTM

• Bachelor’s degree inComputer Science, Information Technology, Healthcare Informatics, or related field
• 5+ years of experience as a Business Analyst inHealthcare / MMIS / Medicaid systems
• Strong expertise infinancial modules: Accounts Receivable (AR), Accounts Payable (AP), and Fiscal Management
• Experience inpayer systems (Commercial, Medicare, Medicaid) and claims processing lifecycle
• Knowledge of healthcare coding systems (CPT, ICD, HCPCS, CDT)
• Proven experience inrequirement gathering, documentation, and gap analysis
• Ability to createfunctional specifications, mapping documents, and Requirements Traceability Matrix (RTM)
• Strong analytical, problem-solving, and data interpretation skills
• Basic technical understanding ofweb services, system integrations, and relational databases
• Hands-on experience withSQL queries for data validation and analysis
• Experience working inAgile or SDLC environments
• Proficiency with tools such asJIRA, Azure DevOps, MS Visio, and SQL clients
• Excellentcommunication and stakeholder management skills
• Ability to collaborate withcross-functional teams (Business, Dev, QA, Clients)
• Understanding of healthcare regulatory requirements and ability to align solutions accordingly

• Qualifications: Graduate
• Range of Year Experience-Min Year: 8
• Range of Year Experience-Max Year: 10