Edifecs · 5 days ago
Sr. Product Analyst
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Health CareSoftware
Insider Connection @Edifecs
Responsibilities
Understanding and defining requirements for CMS encounter submissions
Drafting requirements by analyzing and understanding companion guides and mapping to Product Business Rules and guidelines.
Eliciting requirements using interviews, focus groups, document analysis, requirements workshops, workflow definitions, use cases, scenarios based on Edifecs Product Specifications
Tracking state or CMS websites for data submissions enhancements, understanding the requirements, and developing product impact requirements document
Communicating with customers on Requirement Changes and Release notifications.
Critically evaluating information gathered from multiple sources, reconciling conflicts, decomposing high-level information into details, and distinguishing user requests from the underlying needs.
Collaborating with external and internal customers to analyze information needs and functional requirements to deliver artifacts like BRD, Use cases, GUI, screens, and interfaces.
Collaborating with developers and subject matter experts to develop product specification documents, business architecture and state transition, solution design etc. Utilizing experience in using enterprise-wide requirement definition, management systems, and methodologies.
Qualification
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Required
Bachelors or Master’s degree in Computer Sciences or MBA related fields; Certification in Business Analysis (CBAP) and/or Healthcare (AHM 250) is a plus.
4-5 years’ experience as a business analyst/ Systems Analyst
Good understanding of Healthcare reforms and regulatory framework
Strong knowledge on claim processing for Medicare line of business
Experience working on Medicare Advantage Risk Adjustment methodology
Working knowledge of CMS HCC Model & Risk Scoring
Strong Knowledge on HIPAA X12 837 transactions
Experience in Medicare Encounter data submissions including understanding the acknowledgement processing like 999, 277, MAO etc.
Ability to document product features and functionalities by analyzing various state or CMS requirements for encounter submissions
Experience in interpreting requirements and developing functional specifications
Preferred
Certification in Business Analysis (CBAP) and/or Healthcare (AHM 250)
Experience in using enterprise-wide requirement definition, management systems and methodologies
Benefits
Medical insurance
Dental insurance
Vision insurance
Life insurance
Disability insurance
401(k)-retirement savings plan with matching contribution
Up to 25 days of PTO
10 holidays per year
Company
Edifecs
Edifecs develops information technology solutions to transform the healthcare marketplace.
H1B Sponsorship
Edifecs has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Trends of Total Sponsorships
2023 (60)
2022 (98)
2021 (86)
2020 (59)
Funding
Current Stage
Late StageTotal Funding
$0.53M2020-09-24Undisclosed· $0.53M
2020-07-28Private Equity· Undisclosed
Recent News
2024-04-07
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2024-04-07
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