Greetings,
My name is Kriti and I am Recruiting Manager at eTeam Inc is a global contingency staffing firm servicing fortune 1000 clients across North America, Europe and Asia. We have an excellent job opportunity with one of our clients.
Kindly send the resume to Aeimen Firdous - afirdous@eteaminc.com ,Contact Number: 7323382746
Role: HealthCare Business/Systems Analyst
Location- remote
Responsibilities:
HealthCare domain background experience
· Candidate will work on Conduent's HealthCare claims platform projects.
· Assists in developing Provider Contracts, Fee Schedules and Benefits to ensure efficient implementation and administration.
· Monitor state bulletins and banners to ensure timely, accurate submission and implementation of benefit and/or rate changes.
· Work and communicate effectively with all project stakeholders including the client, vendors, peers and Conduent management
· Analyze and document existing business processes and data, and work towards designing the new processes.
· Facilitate discussions on various functionality challenges and design issues between client, vendor and internal teams
· Perform various levels of system functionality and process testing, document and present test results
· Identify, clarify, and document business requirements
· Create detailed documentation of system incidents/defects
· Create flow diagrams and project documentation
· Recommend solutions to business problems.
· Regular use of Microsoft Word, Excel, PowerPoint, etc. in support of project documentation and communication needs
· Complies with all Policies and Standards
All other duties as assigned
Required Qualifications:
· Bachelor's Degree or equivalent combination of education and experience
· 5 years' experience working as a Business/Systems Analyst
· 3+ years of Provider Contract implementation, contract analysis or claims analysis experience in managed care, health care setting.
· Has clear understanding of rate methodology and contract language.
· Optum CES (Claims Editing Software) or similar Claims Editing System configuration is a plus.
· Experience with Member Eligibility is a plus.
· Demonstrates strong problem solving and analytical skills.
· Demonstrated experience with requirements analysis and documentation.
· Demonstrated experience with the structured testing of systems and business processes.
Preferred Qualifications:
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