| Configuration Solution Analyst Healthcare claims exp must Remote at Remote, Remote, USA |
| Email: [email protected] |
| From: Shraddha Shukla, Technocraft Solutions [email protected] Reply to: [email protected] Hello, I have an urgent role of Configuration Solution Analyst. Please share me your interest on [email protected] Role: Configuration Solution Analyst Long term Remote Job Description TheConfiguration Solutions Analystmust have a thorough understanding of the configuration of business rules in Commercial Healthcare business that support reimbursement policies and methodologies, member/provider contracts, Benefit plans, packages, claims processing, and correspondence and must have demonstrated strong analytical, technical, and problem-solving skills.Duties include, but are not limited to: Configures and maintains the business rules within the Claims Processing ecosystem. Configures the HealthRules (benefits and Package pricing) software from development into testing and deploying to the production environment. Recommends and implements benefit and pricing setup based on knowledge of system configuration capabilities and information obtained from business clients. Independently evaluates business procedures and problems. Hands on working knowledge in resolving production issues related to Benefit configurations. Identifies researches and resolves inaccuracies and inconsistencies in the business rules as they impact claims payment and other upstream and downstream transactions. Resolve configuration defects and perform testing to validate the updates are working as expected. Participates in business requirements gathering sessions to identify specifications and solutions. Evaluate and recommend configuration solutions to Business and IT leadership. Identifies and assesses potential problems and performs and implements system enhancements, modifications and upgrades. Provides application and technical support for the HealthRules software as well as troubleshooting for end users. Works with IT to define business and IT systems requirements. Identifies and assesses potential problems and performs and implements system enhancements, modifications, and upgrades. Mentors and guides business users with the design and impact of configuration changes. Creates test case scenarios for application and configuration testing and ensures appropriate testing has been completed before the changes are deployed into production environment. Designs, develops and maintains user system documentation. Proficiency in Healthcare and Health Plan terminology, medical coding (e.g., CPT, HCPCS, ICD9 & ICD10 CDT, Revenue, DRG and other relevant medical and industry-standard codes) Experience in SQL and other relevant tools and technology used for Benefit configuration updates Experience in Agile methodology and framework Working knowledge of MS Azure DevOps Evaluates and monitors coded data elements. Assists users in understanding business system functions. Additional duties as assigned. Qualifications Bachelor's degree in Business Administration, Management Information Systems, Computer Science or equivalent work experience. In lieu of degree, minimum 3-4 years proven configuration experience in HealthRules and strong project management skills needed. Experience in system migration preferably to HealthRules 4+ years HealthCare operations or Healthcare claims processing experience in Commercial Healthcare business (non-government business) Thanks and Regards, Shraddha Shukla Talent Acquisition Executive Contact: (972) 362-0206 Email:[email protected] Linkedin- linkedin.com/in/shraddha-shukla-599a3212b www.technocraftsol.com | Technocraft Solutions LLC 3974 Brown Park Drive, Suite F Hilliard, Ohio-43026 |
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| Thu Nov 03 20:56:00 UTC 2022 |