Configuration Analysis Analyst

4 weeks ago

chennai, India NTT DATA Services Full time
  • Configuring client System for Pricing (Provider Contract) as per the health plan requirement.
  • Evaluation of Configuration Requirement and Formulation of Configuration Approach and Effectively perform advance configuration based on best practices.
  • Based on the business requirements and configuration standards, evaluate and create benefit/Pricing rules to complete the configuration activities
  • Participate in problem solving of Health Plan benefit, provider, pricing, reporting, operational and system issues.
  • Setting up Benefit plans/Pricing contracts on Amisys and DST system.
  • Perform a variety of tasks not just limited to configuration of benefit/pricing rules but also identifying issues with existing rules resulting in incorrect claim payment.
  • 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 new fee schedule setup, terms, affiliations, and contract maintenance.
  • Enable User Analysis Testing (UAT) and implement the modifications as suggested by business owners.
  • Creating manual test cases from Use cases, Functional specs and other requirement documents.
  • Resolve configuration/QA issues by managing Master Issue Log and fixing the high priority change requests which require immediate attention.
  • Data Validation and Audit of existing plans and contracts in the client database.

  • Required skillset: -

  • Candidates must have Over all 4-6 years’ experience in US healthcare Process such as Claim adjudication, Medical billing/coding, RCM, Member Enrolment.
  • Excellent analytical and problem-solving skills.
  • Bachelor’s degree or any equivalent course.
  • Ability to work within a project-oriented environment.

  • Preferences:  -

  • Experience in SQL 2+ Years (Queries Writing).
  • Exposure with Benefit/Pricing configuration.

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