Job title: Non IT BA
Location: Monterey Park
Duration: until end of 2018
Business Specialist:
Prior job as BA
Some IT background (open to any)
o Desk level process and procedures
o Understanding of the SDLC and PM life cycle and change management
o Architectural data flows
Knowledge of healthcare MUST
Knowledge of EDI
o Claims
Medicare is important.
Required Skills
Familiar with Encounter processing
Medi-Cal knowledge preferred
Understanding of clearinghouses
Familiarity with 5010 file format standards
Provide support to the Care1st Leaders within Claims and Medical Information Systems (MIS) departments. This role will encompass general business analyst activities and deliverables with a heavy focus on assisting with deliverables implementation of a new processing platform. This candidate will help in organizing and scheduling meetings, following up on key decisions and requests for information, issue and decision tracking. The skill set to perform the above duties requires solid understanding of project and resource management, strong business acumen, team focus, experience working in a complex project delivery environment, as well as an advanced understanding of an enterprise project and portfolio management tools.
Project Management Activities: Creating All Necessary Documentation; Working with Stakeholders.
Issue, Action Item, Decision Tracking; Follow up to ensure all requests for information are responded to in a timely manner.
Meeting Organization and Coordination; Meeting Summaries, Next Steps and Follow up
This position is short term temporary position.
At least 3+ years experience in professional & facility claims processing
Strong knowledge in Medi-Cal Claims processing - rules, reimbursements, COB, Shared Risk, special payments for high cost exclusion items, and the Fee Schedules
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