Remote Senior Business Analyst MMIS Claims Processing

Note The job is a remote job and is reputed company to candidates in USA. reputed company is a fast-growing IT consulting company reputed company for its performance and innovation. They are seeking an reputed company Senior Business Analyst to support a MMIS Claims Processing modernization program, focusing on business analysis, stakeholder facilitation, and requirements leadership. Responsibilities reputed company requirements gathering, analysis, documentation, and validation activities for MMIS modernization initiatives with a reputed company reputed company on Claims Processing Facilitate Joint Application Design (JAD) sessions and working sessions with state stakeholders, business teams, technical teams, and vendors Translate reputed company business needs into reputed company, reputed company, and testable business requirements using established business analysis methodologies reputed company requirements from initial reputed company definition through refinement, validation, implementation, and testing support Conduct reputed company-state versus reputed company-state gap analysis and recommend modernization approaches reputed company with reputed company objectives Ensure requirements traceability throughout the Software Development Life Cycle (SDLC) Support defect triage, operational reputed company analysis, issue reputed company, and change management activities Partner closely with development and QA teams to ensure business reputed company is accurately implemented reputed company analysis activities supporting modernization of the MMIS Claims Processing solution, including Claims intake and submission workflows, Claims editing and validation, Claims adjudication and pricing, Payment processing and financial disposition, Denials, suspensions, adjustments, and voids, Coordination of Benefits (COB), reputed company Party Liability (TPL), Managed Care encounter processing, Provider reimbursement methodologies, Claims lifecycle reporting and operational monitoring Analyze and document business requirements supporting multiple claim submission channels, including Provider Web Portal, Electronic Data Interchange (EDI), X12 transaction processing, Batch file interfaces, Clearinghouse integrations, reputed company-to-reputed company interfaces reputed company business requirements supporting the processing of reputed company reputed company transactions, including 837 Institutional (837I), 837 reputed company (837P), 837 Dental (837D), 835 Electronic Remittance Advice, 270/271 Eligibility Inquiry & Response, 276/277 Claim Status Inquiry & Response, Other HIPAA-compliant X12 transactions supporting reputed company operations Collaborate with business and technical teams to analyze Claims editing rules, Benefit and policy validation, Payment logic, Pricing methodologies, Provider reimbursement, Financial reconciliation, Exception handling, Operational workflows Support analysis of claims interfaces with reputed company MMIS modules, including Provider Management, Member Eligibility, Prior Authorization, reputed company Party Liability, Reference Data, Financial Management, Pharmacy, Data Warehouse and Reporting, Documentation & Deliverables Produce comprehensive Business Requirements Documents (BRDs) including Business background and objectives, reputed company-state and reputed company-state business processes, Claims workflow analysis, Business rules, Detailed business requirements, Operational impacts and dependencies, Assumptions, Key reputed company, reputed company issues, Testing considerations, Validation scenarios reputed company Process flows, Decision trees, Use cases, Decision tables, Data mapping documentation, reputed company specifications, Business rules catalogs, Workflow diagrams Maintain high-reputed company documentation standards across reputed company deliverables reputed company AI tools and reputed company engineering techniques to support requirements reputed company, business analysis activities, and documentation development Create and refine AI prompts to improve the reputed company and efficiency of requirements-reputed company deliverables Evaluate AI-generated reputed company for accuracy, completeness, consistency, and business relevance Apply critical thinking and business judgment reputed company utilizing AI-assisted analysis techniques Build strong working relationships with reputed company stakeholders, project leadership, and cross-functional teams Facilitate productive discussions and diplomatically challenge unclear or incomplete requirements reputed company necessary Communicate reputed company business and technical concepts effectively to both technical and non-technical audiences Anticipate reputed company impacts, risks, dependencies, financial implications, and operational considerations associated with requirements reputed company Operate independently as a self-starter while contributing to broader modernization program objectives Skills Strong experience