Manual QA Claims Tester
3B Staffing LLC
Role : Manual QA Claims Testers
Location : Getzville,NY
Duration : 6 + Months
Job Description:
- Facets- hands-on experience in configuration and administration of Trizetto claims solution.
- Healthcare- 5-10 years+ in healthcare claims experience, ideally facets claims systems
- Requirements Management- 5+ years' experience in working with business or IT executives/sponsors to gather requirements, understand business needs and provide solutions.
- Prepared Test cases and Test scripts from the requirements and Functional, Technical specifications.
- Validated member eligibility and eligibility inquiry in the facets application to the legacy application in order to confirm the migration successful or not.
- Experience in Medical, Pharmacy Plan changes from one plan to other plan with in Group, subgroup, class combinations.
- Experience with COB (coordination of benefits) application with in facets, testing of claims status for selected subscribers.
- Writing test cases and test scripts in MS Excel Manually and uploading in Quality center
- Well experienced in benefit coding of different products for various plans of BCBS such as Blue preferred, Blue exchange etc..
- Calculating co-pay, coinsurance, adding single tier, multi tier for different products with in a plan.
- Comparing plan and product details in medical module, and reviewing the benefit summary and feeding them into pivot tables with appropriate co-pay and coinsurance and valid comments for various codes of vision, maternity etc..
- Test data entry into FACETS4.7 application in the test environment for creating groups, subscribers and family members.
- Experience in creating new groups, subgroups, subscribers as and when needed which is later used as a test data for testing purpose.
- Experience in System testing and UAT testing of the facets core application and custom modules as needed.
- Claims validation in Facets application which includes claims pending status, member status, etc..
- Creating test cases, test scripts for various modules, and uploading them into quality center.
Vacancy posted 10 hours ago
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