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    UAT Analyst-2 - Hyderabad, India - Zelis

    Zelis
    Zelis Hyderabad, India

    4 days ago

    Default job background
    Full time
    Description
  • Perform end to end testing to ensure appropriate functionality, product integrity, accuracy, and quality of all changes and enhancements of the edit platform, Data Driven Edits PriZem (in-house system), Visium through the Payment Integrity (Claims Editing) process.
  • Analyze clinical and technical requirements and define the scope of UAT testing. Setup, develop and maintain detailed test scenarios, test suites, data, checklist and/or other documents as specified, ensuring test scenarios align to requirements, adhering to claim adjudication guidelines. While using best practices for software testing methodology and techniques.
  • Analyze and troubleshoot erroneous results, determine root cause, and suggest solutions.
  • Produce documents that are detailed, accurate, and in a consistent format, demonstrating strong analytical and documentation skills.
  • Continuous improvement and refinement of tests-based pre-production validation, post-production results and feedback from other groups (Configuration Department, Content Department and Operations teams) as needed.
  • Support multiple projects, initiatives, tasks, and maintenance releases while adhering to deadlines.
  • Maintain awareness of and ensure adherence to Zelis standards regarding privacy.

    • What You Will bring:

  • Highly organized and results driven.
  • Excellent problem solving and analytical skills.
  • Ability to prioritize and manage multiple concurrent projects.
  • Ability to work through others without direct supervisory responsibility within departments and across the organization.
  • Understanding of medical coding and medical claims.
  • Understanding of the life of a claim, including adjusted/corrected claims.
  • Excellent attention to detail to assess issues and resolve in a timely manner.
  • Basic database skills using MS SQL.
  • Ability to identify key factors and decisions that will make a project successful.
  • Ability to see the big picture and learn new processes, technologies and envision how they could benefit Zelis.
  • Must have excellent communication and presentation skills to effectively interface with team members.

    • education:

  • 2-3 years of relevant experience or equivalent combination of education & work within healthcare payer or provider.
  • Knowledge of healthcare reimbursement methodologies and acceptable billing practices.
  • Knowledge of payer reimbursement policies, state and federal regulations and applicable industry standards.
  • Knowledge of claims adjudication process and interpret claim editing rules.
  • Certified coder (CCS, CCS-P or CPC), or registered health information technician (RHIA/RHIT), or RN, LPN with coding knowledge a plus.
  • Understanding of SQL Server 2000/2005/2008 is a plus.
  • Project management experience a plus.
  • Excellent written, oral and presentation skills and ability to communicate complex concepts.
  • Proficient in Microsoft Office, Word, Excel.
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