Job Description
This position is an entry to mid- level position responsible for the analysis, design, testing and implementation of configuration changes to support business requirements. In addition, this position is responsible for identifying areas of automation and enhancement to support and improve internal workflows. The role requires strong analytical and problem-solving skills, the ability to work independently and proactively as well as demonstrated skills in providing excellent customer service.
Duties and Responsibilities :
- Serve as a resource in facilitating the gathering of business requirements and required test cases for configuration changes.
- Work with key project stakeholders to formulate and communicate business requirements and scope of project.
- Work with project stakeholders to translate their requirements into specifications technical staff can understand and also translate questions that technical staff has into a format the stakeholders can understand.
- Perform all configuration changes within applicable software test environments.
- Responsible for configuration, interface and application testing
- Develop and execute test cases and documentation to support configuration changes/updates/additions.
- Work with stakeholders to validate test case results.
- Coordinating and documenting for all configuration activity for change control and auditing
- Responsible for coordination of production turnover of all configuration work upon business owner sign off.
- Serve as subject matter expert for root cause analysis and issue resolution.
- Coordinate with the Application Support ticket tracking and bringing to resolution any software, configuration, EDI, ICES tickets that require updates to the test or production environments
- Perform business analysis duties for designated corporate projects and maintenance requests.
- Oversee process development and documentation for any new or altered functionality or business process. This will also include facilitating an annual audit of actual business processes versus what is documented.
- Identify potential areas of automation and aid in re-engineering the underlying business processes.
- Recommend and maintain standards for development of business cases and their documentation.
Qualifications Required:
- Associate degree and/or years of experience and background to equate to the degree
- Minimum of two years of business analysis and system configuration experience; or similar demonstrated experience working with health care claim processing
- Prior experience in a Health Care organization or setting.
- Experience with Health Rules or Facets
- Excellent interpersonal skills, including the ability to work across the organization and to interact, influence and negotiate effectively.
- Demonstrated ability to manage multiple priorities simultaneously in a deadline driven environment.
- Proficient in MS Project, Excel, PowerPoint and Word
- Strong communication skills, both verbal and written
Preferred:
- Experience with Acuity software
- Experience with Optum CES (Claims Editing Software)
- Experience with SQL queries
- Experience with Crystal reports/letters
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