Business Analyst

Analyze and configure Accounts Receivable (AR) processes including provider recoupments, recoveries, and fund management within MMIS

Configure and support Accounts Payable (AP) processes including contractor payments, disbursements, and 1099 compliance

Support fiscal management functions including budgeting, fund allocation, and financial tracking

Gather, analyze, and document business requirements from clients and stakeholders

Translate business requirements into functional specifications, business rules, and system configurations

Perform gap analysis by comparing existing system reports (AR, AP, cash receipts, payments) with client-specific requirements

Develop and maintain report specifications for financial modules

Work closely with development, QA, and architecture teams to ensure accurate implementation of requirements

Create interface mapping documents including business rules, data transformation, and database mappings

Support claims processing systems , including provider, member enrollment, and care management workflows

Utilize healthcare reference datasets such as CPT, HCPCS, ICD, CDT in claims adjudication

Participate in testing activities , including validation of test scenarios, test plans, and test data

Support UAT cycles , conduct demos, and track feedback for resolution

Perform data analysis and SQL queries to validate system behavior and troubleshoot issues

Ensure adherence to SDLC processes, documentation standards, and RTM

Bachelor’s degree in Computer Science, Information Technology, Healthcare Informatics, or related field

5+ years of experience as a Business Analyst in Healthcare / MMIS / Medicaid systems

Strong expertise in financial modules : Accounts Receivable (AR), Accounts Payable (AP), and Fiscal Management

Experience in payer systems (Commercial, Medicare, Medicaid) and claims processing lifecycle

Knowledge of healthcare coding systems ( CPT, ICD, HCPCS, CDT )

Proven experience in requirement gathering, documentation, and gap analysis

Ability to create functional specifications, mapping documents, and Requirements Traceability Matrix (RTM)

Strong analytical, problem-solving, and data interpretation skills

Basic technical understanding of web services, system integrations, and relational databases

Hands-on experience with SQL queries for data validation and analysis

Experience working in Agile or SDLC environments

Proficiency with tools such as JIRA, Azure DevOps, MS Visio, and SQL clients

Excellent communication and stakeholder management skills

Ability to collaborate with cross-functional teams (Business, Dev, QA, Clients)

Understanding of healthcare regulatory requirements and ability to align solutions accordingly