*Job Title: Business System Analsyt*
Location: Sunnyvale CA <http://www.zillow.com/sunnyvale-ca/>

*Duration:  Full Time*



*Job Description:*

*Requirements*

·         8-10 years of relevant System Analysis and Configuration
experience with Healthcare Payer/Insurance systems (Medical, Dental and
Behavior Health plans), or equivalent combination of education and work
experience (i.e. undergraduate degree and 4-6 years relevant work
experience)

·         Functional expertise in enrollment processing, claim processing,
provider management, provider contracting and pricing, EDI (HIPAA
Transactions) processing, integration

·         Intermediate skills with TriZetto Facets & QNXT solutions,
including: Hosp & Medical Claims, Processing Control Agent / Set Up,
Product Build from Summary, NetworX Facets Pricing, Core Facets Pricing,
Provider - Networks/Relationships, EDI Eligibilty (HIPAA 834, 270, 271),
Eligibility / Enrollment Data Model & Structure, Member/Eligibility Input &
Output Feeds

·         Intermediate to advanced skills with Microsoft Excel, Access,
Word, Outlook, PowerPoint and Visio

·         Intermediate to advanced skills with SQL and SQL tools (SQL
Developer, TOAD, etc.) with a working knowledge of relational databases and
structure

·         In depth knowledge of Medicaid and Dual Medicare products

·         Experience creating and analyzing business process flow diagrams



*Preferences*

·         Bachelor’s Degree or equivalent training/experience

·         Exceptional verbal and written communication skills, and a strong
client-facing presence

·         Experience on other healthcare insurance payer systems
(ikaSystems, Xcelys, DIAMOND 950, Peradigm, AMISYS, xpress, etc.).

·         Experience with Dual SNIP, MMS/MME

·         Working knowledge of the Affordable Care Act/Health Insurance
Exchange

·         Knowledge of government run programs in the healthcare insurance
industry


 Thanks,

*Patrick Williams*

*Senoir Recruiter*

14301 N ,87th Street
Suite # 317 * Scottsdale, AZ 85260

Phone : 480-787-5609 Ext 102|| Fax :1-(877) 624-0440
Email: *[email protected]* <[email protected]> | http://www.kollasoft.com

           SBE Certified | DBE Certified -State of Arizona

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