Title: Business Analyst III
Duration: 6 months
Location: 100% RemoteJob description:We're looking to fill them as quickly as possible. We're seeking senior-level healthcare payer Business Analysts with strong claims operations experience who can jump in with minimal ramp-up. Ideal candidates will have experience with:
- Medicaid and Medicare claims processing
- Claims adjudication and operational workflows
- Requirements gathering and business process analysis
- Root cause analysis for claim issues and production defects
- Configuration, provider setup, fee schedules, COB/OIC, and claims testing
- Working cross-functionally with Claims, Configuration, IT, Provider Services, and Payment Integrity teams
- UAT, defect management, and implementation support
Centene experience is highly preferred, particularly candidates who have supported Trillium, Health Net, WellCare, or other managed care organizations. Medicaid and Medicare experience is required.
The ideal candidate is a self-starter who can quickly understand complex claims processes, work independently, and immediately contribute to ongoing operational and strategic initiatives.
Please prioritize candidates with significant managed care and health plan claims experience, as we are looking for individuals who can hit the ground running.
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At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws.The pay rate for this position is $61.80/hr.
