Configuration Analysis Senior Specialist

Position's General Duties and Tasks

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.
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• Evaluation of Configuration Requirement and Formulation of Configuration Approach and Effectively include advanced configuration and additional functionality based on best practices
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• Based on the business requirements and business rules gathered, evaluate and create rules and complete the configuration activities
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• Participate in problem solving of Health Plan benefit, provider, pricing, reporting, operational and system issues
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• Perform a variety of tasks related to the resolution of production support issues based on client configurations with the core administrative system
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• 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
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• Support fee schedule changes including terms, affiliations and contract maintenance
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• Enable User Analysis Testing (UAT) and implement the modifications as suggested by the business owners and/or analyst
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• Creating manual test cases from Use cases, Functional specs and other requirement documents.
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• Resolve coding/QA issues by managing Master Issue Logs and Fixing the high priority change requests which require immediate attention
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• Data Validation and Audit of existing plans and contracts in the client database(s)
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• Database Management & Maintenance
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Requirements for this role include:

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• Candidates must have Over all 5+ years’ experience in US healthcare Claims Payer.
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• 6 + year(s) experience in Configuring client System for Pricing (Provider Contract) and UAT testing – 2+ Years.
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• High school diploma or equivalent required, Technical/ Non-Technical
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• Associates degree, technical college or some college course work preferred
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• Ability to work within a project-oriented environment.
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Preferences: -

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• Experience in SQL 2+ Years (Queries Writing)
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• Exposure on VB/Vb.net.
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Required schedule availability for this position is Monday-Friday (5:00am to 3:00pm EST). The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend’s basis business requirement.