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BPO Configuration Analysis Senior Specialist

NTT Data

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.
  • Evaluation of Configuration Requirement and Formulation of Configuration Approach and Effectively include advanced configuration and additional functionality based on best practices
  • 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, typically within the areas of Provider Pricing. Potential responsibilities include and may vary by system area of assignment
  • 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 which require immediate attention
  • Data Validation and Audit of existing plans and contracts in the client database(s)
  • Database Management & Maintenance

Requirements for this role include:

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

Preferences:  -

  • Experience in SQL 2+ Years (Queries Writing)
  • Exposure on VB/Vb.net.  

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.

Vacancy posted 7 days ago
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