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Our client provides access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well. NTT is contracted to manage provider pricing configuration which involves Payor Platform configuration, perform UAT, Integration Testing and Audit.
Job Responsibility
Configuring client System for Pricing (Provider Contract)
Evaluation of Configuration Requirement and Formulation of Configuration Approach
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
Support activities to update configuration within the core claims processing system
Support fee schedule changes including terms, affiliations and contract maintenance
Enable User Analysis Testing (UAT) and implement modifications
Creating manual test cases from Use cases, Functional specs and other requirement documents
Resolve coding/QA issues by managing Master Issue Logs
Data Validation and Audit of existing plans and contracts
Database Management & Maintenance
Requirements
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
Ability to work within a project-oriented environment