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MMIS Business analyst

Remote in Columbia, SC, US • Posted 3 hours ago • Updated 28 minutes ago

Contract W2

On-site

Stellar Professionals LLC

Fitment

Dice Job Match Score™

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Job Details

Skills

Business analyst
MMIS
Claims
CMS
CPT
HCPCS
ICD
Optum
Encoder

Summary

We are looking for a highly skilled MMIS Business analyst to join a fast-paced team focused on critical Medicaid policy and system improvements.

If you are a problem-solver who enjoys bridging the gap between healthcare policy and technical implementation, this role is for you.

Logistics & Details

Work Arrangement: Fully Remote.
Location Requirement: Must be a South Carolina resident. (No relocation allowed).
Interview Process: 1-round, Virtual/Online.
Preferred Skills: Experience in policy remediation, medical claims processing systems, and Optum Encoder.

The Position

You will serve as a Subject Matter Expert (SME), translating complex federal medical coding requirements (ICD-10, CPT/HCPCS) into functional business rules. You will collaborate with IT developers to ensure the Medicaid Management Information System (MMIS) reflects accurate policy changes for seamless claims adjudication.

Core Qualifications

Healthcare Expertise: 5+ years in healthcare insurance (program integrity, appeals, or medical review).
Coding Mastery: 5+ years of Medical Coding experience specifically in a payer environment.
Technical Collaboration: 5+ years working directly with IT developers/programmers to translate requirements.
Clinical Background: 3+ years of clinical experience (demonstrating strong assessment/critical thinking skills).
Coding Knowledge: Deep proficiency in ICD/CPT/HCPCS translation and methodologies.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: 91138038
Position Id: 2026-11389
Posted 3 hours ago

Company Info

About Stellar Professionals LLC

Stellar Professionals LLC stands out in the industry, offering a distinctive fusion of over 15 years of seasoned Staffing professionals and a vibrant community of over 150,000 LinkedIn followers. Our AGILE Staffing services are tailored to assist businesses in finding the ideal talent for their projects. In contrast, our Client Acquisition Services are focused on securing more public/private sector projects. Our disruptive approach to staffing and business consulting, encapsulated in our motto 'Agility and Excellence,' truly sets us apart. Contact us today to explore how we can transform your business. Stellar Professionals has a proven track record of success, offering comprehensive capabilities and profound industry knowledge to help you tackle your organization's most intricate issues.

Since our establishment, we have consistently broadened our client base, with a burgeoning roster of returning and new clients each year. This steady expansion is a testament to the value and caliber of our services, instilling unwavering confidence in our potential clients. Many remarkable people want to do something significant but different. With over 15 years of experience in the Talent Acquisition and Staffing industry, we found that Staffing agencies spend a lot of money on Business Development and recruitment activities with low ROI. Therefore, we at Stellar Professionals LLC develop an innovative, cost-effective solution to help you build great Business partnerships and increase revenue.

Stellar Professionals LLC is currently accepting resumes for a variety of positions. Please review the database of positions that we are seeking to fill and contact us for additional information about any specific opportunity.

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