Job Description :
VDart We are a Global Information Technology Services & Workforce Solutions firm headquartered out of Atlanta, GA with presence in US, Canada, MX, UK, Belgium, Japan & India. Founded in 2007, Our team of over 2550+ professionals continually create impact for our customers worldwide in solving complex technology challenges with cutting edge technologies. We specialize in providing the Fortune 1000 companies, niche hard to find skills in technologies including Social, Mobile, Big Data Analytics, Data Sciences, Cyber Security, IoT, Cloud, Machine Learning, and Artificial Intelligence. With delivery centers in the UK, Mexico, Canada, and India, we provide global workforce solutions to our customers covering EMEA, APAC & Americas. VDart is an award-winning organization recognized by Inc 5000 Hall of Fame; Atlanta Business Chronicle*s Fastest Growing Companies; NMSDC*s National Supplier of the Year; Ernst & Young*s Regional Entrepreneur of the Year and more. Job Title: Business Analyst - Claims Adjudication Location: Glen Allen VA Duration: 6 months 7+ years of experience working in an operations role at a health plan 4+ years of Healthcare experience in any of the following: Government Programs, PBM, Clinical Health Management, Core Administer Delivery, Program Management, Product Management, or Network Management 2+ years of experience in one or more of the following: Operational business process improvement, business process analysis, benchmark analysis or workflow analysis Ability to work on claims with different LOBs such as Commercial, Medicare, Medicaid etc. Knowledge and experience of Medicare & Medicaid state level reporting levels Strong Knowledge/Experience with Dimensional Modeling Strong understanding of healthcare data formats, standards, and can map them to CMS and state level reporting needs Good understanding on the lifecycle of claims adjudication Possess good exposure on the various claim functionalities such as Edits, COBs, claims adjustments, Episodes etc. If your skills match our requirements, *; Be sure to reference the job number and title in the subject line. Referral Program: Ask our recruiting team about how you can be a part of our referral program. If you refer a candidate with this background and if the candidate accepts the role our team pays a generous referral. We are keen on networking and establishing a long-term, mutually beneficial partnership with you. We are Equal Employment Opportunity Employer. VDart Inc Alpharetta, GA Click here to Apply Follow us on Twitter for the hottest positions: @VDart_Jobs Follow us on Twitter: @vdartinc