| Business Analyst with Healthcare - Raleigh, NC at Raleigh, North Carolina, USA |
| Email: [email protected] |
| From: Irfan, Innozatech [email protected] Reply to: [email protected] This position is responsible for the following activities : Demonstrated knowledge in creating test scenarios/cases in consultation with the business owners, hands-on testing, test results review, and proactively identifying issues and providing resolutions/recommendations Proven knowledge in Medicaid or similar claims ( pharmacy) processing systems Extensive knowledge of pharmacy claims and business policies Thorough knowledge of system functional areas such as recipient, provider, prior authorization, reference, program integrity, financial and claims Thorough knowledge of Federal and State regulations, statutes, and rules Knowledge base/experience with encounter claims and be ready to lead any work effort pertaining to encounter claims Expert knowledge on SQL, EDI, X12, NCPDP, HL7, HIPAA PHI, ICD-10 Clear understanding of the deliverables process, e.g. System Documentation release, Working knowledge of defect process Proven experience with the system development life cycle (SDLC) Experience working on large Federal/State contracts Proficient with Microsoft Word, Excel, Visio, Project, OneNote, Outlook, and PowerPoint Skill Required / Desired Amount of Experience Experience with Healthcare Pharmacy Claims Processing Required 3 Years Experience in the review, analysis and reporting of test results. Required 5 Years Experience on testing web applications Required 5 Years Excellent verbal and written communication skills with the ability present to both technical and business audiences. Desired Proven experience developing SQL queries. Required 2 Years Knowledge of Agile Methodology Required 3 Years Experience in working with the Business Teams to write Business and QA Documents . Required 3 Years Experience in validating all pharmacy interfaces/files Required 3 Years Keywords: quality analyst |
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| Sun Dec 11 17:26:00 UTC 2022 |