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Join our team as a Senior BPO Configuration Analyst and play a key role in configuring provider contracts and pricing systems for US healthcare claims. Leverage your expertise in system configuration, UAT testing, and SQL to drive operational excellence. Grow your career in a dynamic, project-oriented environment with opportunities for impact and advancement.
Job Responsibility
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
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
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
Data Validation and Audit of existing plans and contracts in the client database(s)
Database Management and Maintenance
Requirements
Overall 5+ years experience in US healthcare Claims Payer
6+ years experience in Configuring client System for Pricing (Provider Contract)
UAT testing - 2+ Years
High school diploma or equivalent required
Ability to work within a project-oriented environment