AZ, United States
11 days ago
Business Analyst (Payment Policy)

JOB DESCRIPTION

Job Summary

Analyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Assist with HTML, CSS and Javascript coding.   Reviewing medical records and verifying reimbursements are configured and submitted correctly.    Verifies medical billing and coding meet state and federal medical regulations.

KNOWLEDGE/SKILLS/ABILITIES

Provides analytical, problem solving foundation including: definition and documentation, specifications.  Recognizes, identifies and documents changes to existing business processes and identifies new opportunities for process developments and improvements. Reviews, researches, analyzes and evaluates all data relating to specific area of expertise. Begins process of becoming subject matter expert. Conducts analysis and uses analytical skills to identify root cause and assist with problem management as it relates to state requirements. Analyzes business workflow and system needs for conversions and migrations to ensure that encounter, recovery and cost savings regulations are met Prepares high level user documentation and training materials as needed.

JOB QUALIFICATIONS

Required Education

Associate's Degree or equivalent combination of education and experience

Required Experience

3-5 Years of business analysis 4+ years managed care experience Demonstrates familiarity in a variety of concepts, practices, and procedures applicable to job-related subject areas.

Preferred Education

Bachelor's Degree or equivalent combination of education and experience

Preferred Experience

1-3 years formal training in Business Analysis and/or Systems Analysis HTML, CSS, and JavaScript coding skills Experience reviewing medical records. Medical reimbursement knowledge Billing and coding expertise Familiarity with state and federal medical regulations Strong writing abilities and SharePoint proficiency

 

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

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