Please go through the below requirements and send 

updated resumes. Thank you!

 

Hi,

 

Please let me know, if you have any consultant for the below requirement.
Thanks!

 

 

Role: Business System Analyst with Health Care

Location: Owing Mills, MD

Duration: 6 Months.

 

Job Description:

 

Submit MTM Audit Memorandums (MAMS) to Operations Management that outline
the root cause of identified issues as well as provide recommendations for
corrective action, system and procedural modification and enhancements to
improve service and quality. Issues may include, but are not limited to:
weaknesses, inconsistencies and inaccuracies in procedures, controls and
system integrity. 

Compile, analyze and report any fraudulent activity or information to the
appropriate departments. This information or activity may represent a
potential risk to the corporation, its subscribers, accounts and providers.
The area that may obtain this information may include, but is not limited
to: Special Investigations Unit, HIPAA Privacy Office, and/or Compliance
Office depending on the nature of the information identified. 


MINIMUM QUALIFICATIONS: 
Experience /Abilities/Skills: 
B.S./B.A. degree, or equivalent work experience, along with: 
A minimum of three years claims/service/enrollment and billing experience or
other comparable work experience. 
Basic understanding of MTM Reporting System 
Strong knowledge of claims, inquiry, or enrollment processing on a minimum
of two platforms: FACETS, FLEXX, NASCO for a minimum of two measures
(claims, enrollment, inquiry, group) 
Moderate understanding of ICD9 coding, CPT coding, medical terminology and
the CareFirst Standard Operating Procedures 
Strong PC skills (Lotus Notes, Word, Excel) 
Strong analytical and problem solving skills 
Moderate ability to read and interpret data screens which may include but
are not limited to: GMIR, BCIQ, BEI, IACS, CSW, HIQK, OBN, PV40 for two
platforms: FACETS, FLEXX, NASCO 
Ability to read and interpret contracts 
Ability to research and document audit issues 
Basic knowledge of statistics 
Ability to make independent decisions 
Strong interpersonal skills 
Ability to interact with multiple levels of Associates & Management 
Ability to multi-task and change priorities as needed 
Ability to work both independently and as a member of a team 
Effective communication skills (verbal and written) 
Professional attitude & professional attire required 

Preferred: Two or more years Quality Assurance experience. 



 

Thanks and Regards,

 

Gideon Naresh

AIM Computer Consulting | 734-591-3562 Ext 1204

Fax: (734) 418-2603 |  <mailto:[email protected]> [email protected]  |
<http://www.aim-cc.com> www.aim-cc.com |  <mailto:[email protected]>
[email protected]

 

cid:[email protected]

 

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