BPO Configuration Analysis Senior Specialist

NTT DATA BUSINESS SOLUTIONS; Chennai District; On-site; INR 900,000 - 1,300,000; Full time

Job summary

NTT DATA BUSINESS SOLUTIONS in Chennai, Tamil Nadu, is seeking a seasoned Healthcare Claims Configurator to join our delivery team. You will configure pricing/provider contracts within the blueprints of the new claims processing platform and ensure alignment with business rules.

The role requires 5+ years in US healthcare claims payer, strong SQL and VB.NET skills, and hands-on UAT experience in a project-driven environment. On-site collaboration with client teams is expected.

Qualifications

• 5+ years of experience in US healthcare Claims Payer.
• 6+ years of experience configuring client system for pricing (Provider Contract) and 2+ years of UAT testing.
• High school diploma or equivalent required, Technical/Non-Technical
• Associates degree, technical college or some college coursework preferred
• Ability to work within a project-oriented environment.

Responsibilities

• Configuring client System for Pricing (Provider Contract) as per requirements and business rules of new claims processing platform.
• Evaluation of 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 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.
• 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

Skills

US healthcare Claims Payer

UAT testing

Data validation

Production support

VB.NET

SQL (queries)

Education

High school diploma or equivalent

Associates degree or some college

Job description

Job Summary 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 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 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

Requirements

• Candidates must have overall 5+ years of experience in US healthcare Claims Payer.
• 6+ years of experience in configuring client system for pricing (Provider Contract) and 2+ years of UAT testing.
• High school diploma or equivalent required, Technical/Non-Technical
• Associates degree, technical college or some college course work preferred
• Ability to work within a project-oriented environment.

Preferences

• Experience in SQL 2+ years (queries writing)
• Exposure to VB.NET

Required schedule availability for this position is Monday-Friday (5:00am to 3:00pm EST). The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekends basis business requirement.