Business Analyst

Position: Business Analyst

Location Remote

Employment Type Full-Time

MMIS Financial Business Analyst (AR/AP & Fiscal Management)

Role Summary

The MMIS Financial Business Analyst is responsible for analyzing, configuring, and supporting financial modules within Medicaid Management Information Systems (MMIS), including Accounts Receivable (AR), Accounts Payable (AP), and Fiscal Management functions. The role involves working closely with clients, stakeholders, and technical teams to define requirements, configure financial processes, and ensure compliance with healthcare payer systems, regulatory standards, and business needs.

Roles & Responsibilities

• 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

Skillset & Qualifications

• 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