Provider Configuration and Pricing - US
- Ntt Data Global
- 5 - 10 years
- Chennai
- 4 years ago
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Job Description
Roles and Responsibilities
- Configuring client System for Pricing (Provider Contract) as per the requirement and according to defined business rules of new claims processing platform.
- Evaluation of Pricing 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 pricing 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
Desired Candidate Profile
- Preferring short joiners ( Max notice period - 30 days)
- 5 to 10 years of experience completing the configuration and design of provider contracts
- 4 to 5 years of Provider pricing configuration experience
- 3+ years conducting UAT in provider contracts.
- Preferred 3+ years of experience completing or working with business requirements and/or functional design documents
- Possesses strong knowledge of claims processing and associated business processes
- Prior experience working with DST system pricer and Amysis system knowledge is a plus
- Ability to create and run basic system queries using SQL, Access or other tools is required
- Preferred: Knowledge of US Government HealthCare Plans Medicaid/Medicare
Perks and Benefits
Work from home during this pandemic
Please send your resume to jo*****m@nt****a.com
Regards
Jobesh Mani
9524797***
Job Classification
Industry: BPO, Call Centre, ITeSFunctional Area: IT Software - Application Programming, Maintenance,
Role Category: System Design/Implementation/ERP/CRM
Role: System Design/Implementation/ERP/CRM
Employement Type: Full time
Education
Under Graduation: Any Graduate in Any SpecializationPost Graduation: Any Postgraduate in Any Specialization
Doctorate: Doctorate Not Required, Any Doctorate in Any Specialization
Contact Details:
Company: NTT Data Information Processing ServicesAddress: No.18 18/1,South End Road, , , BANGALORE, Karnataka, India
Location(s): Chennai
Keyskills: NetworX Configuration DST system Pricer Medicare CPT UAT US Healthcare Provider Contracts User Analysis Testing FACET Amysis Pricing Healthcare Medicaid
Ntt Data Global
NTT DATA GLOBAL DELIVERY SERVICES PRIVATE LIMITED - NTT DATA is a publicly traded company, but is about 54 percent owned by NTT. Its business areas are in national and local governments, financial, and telecommunication sectors. According to reports in 2012, Forbes Global 2000 recognizes NTT DATA...
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