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Medicaid Analyst - Raleigh, North Carolina


As a member of the corporate team, you’ll focus on enhancing the relationship with our clients as we provide outstanding business solution services. Within departments like Accounting & Finance, Human Resources, and Engineering, Conduent is actively staffing all teams with roles like Recovery Analyst, Client Services Specialist, and Senior Management Consultant. At Conduent, we give our employees the opportunity to further develop their career skills with the intention of growing them into leaders within the organization.

  • Full Time
  • Experienced
  • Professional Development Opportunities

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  • Multi-Tasker 8
  • Strategic 10
  • Expressive Presenter 6
  • Conceptual 4
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  • Healthcare

    Conduent is proud to offer comprehensive and competitive benefits that reflect the value of our employees. Benefits will differ by country, please contact your recruiter for details specific to your location.

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Requisition ID: 17028531
Primary Location:United States-North Carolina-Raleigh
Other Locations:United States-Kentucky-Lexington
Category:IM Business Analysis
Conduent is the world's largest provider of diversified business process services with leading capabilities in transaction processing, automation, analytics and constituent experience. We work with both government and commercial customers in assisting them to deliver quality services to the people they serve.

We manage interactions with patients and the insured for a significant portion of the U.S. healthcare industry. We are the customer interface for large segments of the technology industry and the operational and processing partner of choice for public transportation systems around the world.

Whether it's digital payments, claims processing, benefit administration, automated tolling, customer care or distributed learning - Conduent manages and modernizes these interactions to create value for both our clients and their constituents. Learn more at

Conduent is looking for an experienced Business/Systems Analyst who will work on a Medicaid Managed Care Organization:’s claims processing system and peripheral systems. The ideal candidate must have experience in healthcare services/systems, preferably with a claims administration/adjudication system. Candidate should have a solid HealthCare domain background and keep up-to-date with advancements in healthcare and related IT systems, tools, and technologies. Apart from education and experience, the ideal candidate will have strong analysis and design experience, along with technical, and communication skills.
  • Gather and document clear requirements from the client on changes requested to IT Systems
  • Communicate detailed requirements, accurate timelines, and the correct project scope to internal and external teams
  • Help with planning, design and implement changes to the current system to achieve desired functionality and/or efficiency improvements.
  • Create flow diagrams and design documents, to be used in project data repository.
  • Gather and document existing processes and data in order to perform gap analysis between current system and desired system in order to increase efficiency.
  • Facilitate discussions on various functionality challenges and design issues, between client, vendor and internal teams
  • Create new processes/procedures/guidelines to improve processes and systems.
  • Train team members and new associates on the billing and coding systems
  • Serves as liaison between the client and development teams for technical issues
  • Coordinates across multiple teams, both internal and external, to facilitate timely and quality implementations of IT initiatives
  • Create system incidents/defects, provide input to help tracking and resolving them in Production and lower environments
  • Coordinates activities related to the design, development and implementation of system enhancements and modifications with Dev and IT teams.
  • Helps with the efficient and reliable operations of business processes
  • Reviews current status of system applications and prepares recommendations for improvements.
    All other duties as assigned.

Required Qualifications:
  • 5 years’ experience in the HealthCare domain
  • Ideal candidate would have worked on Claims Administration/Adjudication system
  • Should have experience with a rules engine such as a Claims Edit System
  • Preferred candidate would have experience with member eligibility/enrollment, preferable for the State of California.
  • Ideal candidate would have Medical billing and coding certifications from AAPC
  • Have a basic understanding of Web Services and how they interact with other services.
  • Should be comfortable with basic queries and data gathering from MS-SQL and any other database

Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the "Submit" button at the bottom of the form. For those using Google Chrome or Mozilla Firefox please download the form first: click here to access or download the form.

Travel:Yes, 25 % of the Time
Job Type:Experienced
Organization:Financial Service + Healthcare

The Conduent difference

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