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The UAT Analyst will be responsible for creating test plan, test scenarios, setup, execution of UAT testing and reviewing results for all healthcare claim editing related projects within the Payment Integrity department including, but not limited to the testing of new data driven edits, configuration, platform initiatives, and UI initiatives.
Job Responsibility:
Perform end to end testing to ensure appropriate functionality, product integrity, accuracy, and quality of all changes and enhancements of the edit platform
Analyze clinical and technical requirements and define the scope of UAT testing
Setup, develop and maintain detailed test scenarios, test suites, data, checklist and/or other documents as specified
Analyze and troubleshoot erroneous results, determine root cause, and suggest solutions
Produce documents that are detailed, accurate, and in a consistent format
Continuous improvement and refinement of tests-based pre-production validation, post-production results and feedback
Support multiple projects, initiatives, tasks, and maintenance releases while adhering to deadlines
Maintain awareness of and ensure adherence to Zelis standards regarding privacy
Requirements:
2-3 years of relevant experience or equivalent combination of education & work within healthcare payer or provider
Knowledge of healthcare reimbursement methodologies and acceptable billing practices
Knowledge of payer reimbursement policies, state and federal regulations and applicable industry standards
Knowledge of claims adjudication process and interpret claim editing rules
Excellent written, oral and presentation skills and ability to communicate complex concepts
Proficient in Microsoft Office, Word, Excel
Nice to have:
Certified coder (CCS, CCS-P or CPC), or registered health information technician (RHIA/RHIT), or RN, LPN with coding knowledge