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Configuration Analysis Analyst

4 months ago

Chennai, India NTT DATA Full time

Job Description

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 activitiesParticipate 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. Apply from local Career site

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