Hi,

We have One Layer between Client and us and if you are Interested to work
with us then Please submit Resumes to sur...@aim-cc.com

Role: Business System Analyst with *MTM Reporting System*

Location: Owing Mills, MD

Duration: 6 Months.

Rate: $47/hr



*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, **or **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.

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