Senior Analyst - BPO Configuration and Claims Pricing

BPO Configuration Analysis Senior Analyst

In these roles you will be responsible for: 
•    Configuring client System for Pricing (Provider Contract) as per the requirement and according to defined business rules of new claims processing platform.
•    Evaluation of Configuration Requirement and Formulation of Configuration Approach and Effectively include advanced configuration and additional functionality based on best practices
•    Based on the business requirements and business rules gathered, evaluate and create rules and complete the configuration activities 
•    Participate in problem solving of Health Plan benefit, provider, pricing, reporting, operational and system issues
•    Perform a variety of tasks related to the resolution of production support issues based on client configurations with the core administrative system
•    Support activities to update configuration within the core claims processing system, typically within the areas of Provider Pricing. Potential responsibilities include and may vary by system area of assignment
•    Support fee schedule changes including terms, affiliations and contract maintenance
•    Enable User Analysis Testing (UAT) and implement the modifications as suggested by the business owners and/or analyst
•    Creating manual test cases from Use cases, Functional specs and other requirement documents.
•    Resolve coding/QA issues by managing Master Issue Logs and Fixing the high priority change requests which require immediate attention
•    Data Validation and Audit of existing plans and contracts in the client database(s)
•    Database Management & Maintenance
Requirements for this role include: 
•    Candidates must have Over all 5+ years’ experience in US healthcare Claims Payer.
•    3 + year(s) experience in Configuring client System for Pricing (Provider Contract) and UAT testing.
•    High school diploma or equivalent required, Technical/ Non-Technical
•    Associates degree, technical college or some college course work preferred
•    Ability to work within a project-oriented environment.

Preferences:  - 
•    Experience in SQL 2+ Years (Queries Writing)
•    Exposure on VB/Vb.net.  

Experience Level

Senior Level