Req ID: 390352
NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.
We are currently seeking a Sr. Medicaid TPL Business Analyst-Local Candidates To Little Rock, AR to join our team in Little Rock, Arkansas (US-AR), United States (US).
We are seeking a Senior Business Analyst with deep expertise in Medicaid Third Party Liability (TPL), claims processing, and recovery operations. The ideal candidate will have hands-on and in-depth experience and knowledge with Medicaid Management Information System (MMIS), Coordination of Benefits (COB), Crossovers – (Medicare A & B), Medicare Advantage C plans (MCA), and post-payment recovery workflows. The TPL SR BA will support Business Operations Support (BOS) for a state Medicaid Program. Working under the direction of the Operations Manager, the analyst will collaborate with state business staff, system and service vendors, and NTT DATA project managers and consultants to support planning, design, User Acceptance Testing (UAT), implementation, and evaluation of key system and processes changes.
Location: Little Rock, AR
Key Responsibilities
• Analyze Medicaid claims, TPL workflows, Medicare Crossovers (Pt A&B), Medicare Advantage (Pt C), and recovery data to identify trends, root causes, and opportunities for cost avoidance and recovery optimization
• Translate federal/state TPL policies into system requirements
• Support MMIS enhancements, including adjudication rules and edits, reporting, letters, etc.
• Work with vendors and state stakeholders to improve all faucets of insurance discovery and recovery processes
• Lead requirements gathering, documentation, create and conduct UAT testing
• Identify and report issues, risks, and dependencies
• Support issue triage, backlog management, and operational reporting for day-to-day TPL activities
Required Qualifications:
• Minimum 6 years of experience supporting large, complex Medicaid system implementation projects and/or Medicaid business operations
• Minimum 6 years of experience with TPL, Coordination of Benefits, Medicare Crossover Part (A&B) Claims processing, Medicare Advantage (Part C), claims workflows, including complex claim scenarios and regulatory compliance.
• Minimum 6 years of experience with elicitation and verification of business and technical requirements
• Minimum 3 years