Verified Job
Customer Support / TeleCaller
Senior Analyst - BPO Configuration and Claims Pricing
Customer Support / TeleCaller
#689345
Remote / WFH
Job Description
Job description
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
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
