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Listed below are the top 10 out of 127 listings that are in the same industry and location as the job you were looking for. To see more than 10 listings, click here to search similar jobs in NASHVILLE, TN
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For your reference, we have included the original job posting below.
Business Analyst Associate Professional
Job Number:
20114453
Company Name:
CSC
Job Location:
NASHVILLE, TN US
Job Category:
Information Technology
Business Analyst Associate Professional
Title: Business Analyst Associate Professional Location: TN: TENNESSEE-NASHVILLE Essential Job Functions * Primarily responsible for conducting reviews of medical records, applying Medicare guidelines in addition to a working knowledge of DRG assignment, ICD-9-CM and CPT-4 coding. Applies a knowledge of integrated health care systems and Medicare guidelines during the course of fraud investigations or other benefit integrity initiatives such as requests for information or in support of proactive data analysis efforts. * Reviews information contained in Standard Claims Processing System files to determine provider billing patterns and to detect potentially fraudulent or abusive billing practices or vulnerabilities in Medicare payment policies. * Coordinates and compiles the written Investigative Summary Report to the BI Analyst upon completion of the records review. * Provides expert testimony as required.
Basic Qualifications * Bachelor's degree or equivalent combination of education and experience * Bachelor's degree in business administration, information systems, or related field preferred * Must hold one of the following current certifications: * Accredited Record Technician (ART) * Registered Record Administrator (RRA) * Must have no adverse actions pending or taken against him/her by any State or Federal licensing board or program; and must have no conflict of interest (COI) as defined in 1154(b)(1) of the Social Security Act * Five or more years experience using knowledge of ICD-9-CM, HCPCS Level II and CPT-4 coding DRG codes * Knowledge of Standard Claims Processing System files * Medicare experience is preferred * Zero or more years of business analysis experience * Experience working with the interface of information technology with functional groups within an organization * Experience working with business processes and re-engineering * Experience working with computer programming concepts and basic language * Other Qualifications * Basic interpersonal skills to interact with customers and team members * Basic communication skills * Basic analytical and problem solving skills * Basic presentation skills to communicate with management and customers * Basic personal computer and business solutions software skill * Ability to work in a team environment * Willingness to travel
