Business Analyst

• Perform provider data management activities based on plan and contract specifications and standard business rules
• Analyze and enter data
• Review data via internet sites and other systems
• Use multiple systems and applications to validate data completeness and accuracy
• Manage provider enrollment and data updates
• Ensure claims and provider directory accuracy
• Resolve system issues through research and quality checks
• Enroll providers and practitioners into the provider data management system
• Update provider and practitioners with claims payment and directory information
• Research, review, and update the provider data management system per provider requests
• Perform quality service checks on systemic data, including claims processing and provider directory information
• Research and resolve problems as necessary

Provider Data Management Analyst I

• Support a Medicaid provider enrollment modernization initiative
• Facilitate discovery sessions with Medicaid policy, provider enrollment, operations, technical, security, and vendor stakeholders
• Analyze current provider enrollment processes, workflows, business rules, system interfaces, forms, notices, and operational pain points
• Elicit, document, validate, and maintain business, functional, nonfunctional, data, and integration requirements
• Translate business needs into user stories, use cases, process flows, business rules, requirements traceability documentation, and acceptance criteria
• Define requirements for a provider-facing enrollment portal supporting application initiation, saving, submission, document upload, and status tracking
• Document portal workflows, page flows, data requirements, user roles, and navigation needs with UI/UX and development teams
• Support authentication, role-based access, accessibility, security, and enterprise identity-management integration requirements
• Analyze and document OnBase workflow enhancements for provider screening, licensing validation, risk assignment, notifications, site visits, fraud indicators, status changes, and work-queue automation
• Define data mappings, interface requirements, ingestion rules, validation rules, exception handling, and two-way data exchanges across OnBase, MMIS, portal, and integration teams
• Analyze provider enrollment data involving NPIs, taxonomy, licenses, affiliations, revalidation, ownership, group and individual relationships, and ordering/referring/prescribing providers
• Identify opportunities to reduce manual processing, improve data quality, increase workflow visibility, and automate enrollment activities
• Coordinate stakeholders to clarify requirements, resolve gaps, manage changes, and evaluate downstream impacts
• Review system designs and technical artifacts for alignment with approved requirements
• Support sprint planning, backlog refinement, demonstrations, defect review, and other Agile activities
• Develop test scenarios and expected results from approved requirements and business rules
• Support system integration testing, user acceptance testing, regression testing, defect triage, and functionality validation
• Maintain requirements traceability through design, development, testing, and implementation
• Prepare status updates, meeting notes, decision logs, risk and issue documentation, and other project artifacts

Senior Business Analyst – Medicaid Provider Enrollment Modernization

• Support business initiatives through data analysis, identification of implementation barriers, and user acceptance testing of various systems
• Identify and analyze user requirements, procedures, and problems to improve existing processes
• Perform detailed analysis on multiple projects, recommend potential business solutions, and ensure successful implementations
• Identify ways to enhance performance management and operational reports related to new business implementation processes
• Coordinate with various business units and departments in the development and delivery of training programs
• Develop, share, and incorporate organizational best practices into business applications
• Diagnose problems and identify opportunities for process redesign and improvement
• Formulate and update departmental policies and procedures
• Serve as the subject matter expert on the assigned function product to ensure operational performance
• Comply with all policies and standards

Business Analyst III – Encounters, Claims, EDI, SQL

• Formulate and define business scope and objectives through research and fact-finding
• Analyze business and industry requirements
• Perform functional analysis, requirements definition, application module configuration, and testing
• Conduct prototypes and develop functional specifications
• Perform data mapping and function mapping
• Set configuration tables and transaction/control tables
• Analyze business requirements and develop solutions for business functions
• Identify and resolve gaps in business processes
• Configure security and authorization settings
• Develop user documentation
• Design data interfaces
• Perform data migration and reconciliation
• Assist with installation and tuning of modifications
• Archive data
• Develop necessary workarounds using light programming skills
• Collaborate with business partners, vendors, professional peers, and team members to deliver business solutions

Associate Principal – Business Solutions Analyst

• Project manage two technology imperatives, driving initiatives between operations and technology teams
• Document business requirements representing business needs
• Quickly understand and shadow new business processes to drive technology needs
• Analyze and evaluate existing RCM systems and processes for improvement and optimization
• Maintain workflow platform and other system configuration and setup
• Monitor SLAs and KPIs and provide leadership insights
• Develop and implement strategies to streamline revenue cycle processes
• Partner with leaders to improve billing, coding, and collections workflows
• Generate and analyze revenue cycle performance reports
• Provide dashboard and regular reporting recommendations to management
• Ensure compliance with healthcare billing and coding regulations, standards, and policies
• Provide technical support and training to staff on RCM systems and software
• Collaborate with finance, IT, and clinical teams
• Assist with RCM system upgrades and new technology integrations
• Identify and resolve RCM system and process issues
• Maintain comprehensive documentation of RCM processes, systems, and procedures

Business Analyst jobs in Missouri

Provider Data Management Analyst I

Senior Business Analyst – Medicaid Provider Enrollment Modernization

Business Analyst III – Encounters, Claims, EDI, SQL

Associate Principal – Business Solutions Analyst

RCM Systems, Business Analyst