Job Description

Short Description:

NC DHHS is seeking a Business Systems Analyst. This position will serve as a member of the Business Technology Relationship Management team.

Complete Description:

This position will serve as a member of the Business Technology Relationship Management team. The unit is responsible for managing relationship between the DHB program/functional areas and the Technology that supports the business and supports all of the division.

Job Specific Responsibilities

- Review of various claims reports to perform in-depth claim analysis, validation of system changes, and review of edits/audits in order to make recommendations to maintain the integrity of the reprocessing.

- Provide incident monitoring, problem ticket, incident creation and troubleshooting.

- Defect Resolution

- Requesting System Enhancements

Preferred Knowledge, Skills, and Abilities:

- Experience working with NC Medicaid

- Experience with NCTracks

- Experience with gathering requirements

- Experience working with claims adjudication/reprocessing

- An understanding of claim edits and audits

- Strong understanding of health care strategy, operations, technology, and regulatory requirements

- Demonstrated ability to work independently in a fast-paced environment with concurrent deadlines

- Excellent communication, negotiation, conflict resolution and persuasion abilities

- Strong organizational, time management, communication, and detail-oriented skills

- Highly proficient with Microsoft Outlook, Word and Excel