SAP QA Analyst

Otomeyt; Hyderabad, Pune District, Bengaluru; Hybrid; INR 350,000 - 550,000; Full time

Job summary

Otomeyt is seeking a specialist in healthcare claims processing to support the lifecycle from adjudication through EOB, working in a TriZetto Facets environment. You will handle claims data, provider Records, and financial extracts while aligning with HIPAA EDI standards.

You will also manage financial postings, payments, denials, and adjustments, and collaborate across ECC integrations and payment systems. Proficiency with ADO and test automation, plus reporting and data analysis, is required.

Qualifications

• Experience with healthcare claims processing and EDI standards.
• Understanding of TriZetto Facets.
• Familiarity with healthcare payments and remittance.

Responsibilities

• Work with the claims lifecycle processing including adjudication, fee schedules, RCM, provider networks and EOB.
• Operate within a TriZetto Facets environment to access claims data, provider records, and financial extracts.
• Work with healthcare EDI standards such as HIPAA 837 Claims, 835 Remittance Advice, and 834 Enrolment.
• Handle financial postings including debits/credits, payments, denials and adjustments.
• Integrate ECC systems and payment/disbursement platforms.
• Utilize ADO and test automation tools and perform data analysis for reporting.

Skills

Claims lifecycle

Adjudication

Fee schedules

RCM

Provider networks

EOB

Facets

EDI HIPAA 837

EDI 835

EDI 834

Financial postings

Debits credits

Payments/denials

ECC integrations

Payment systems

ADO

Test automation

Reporting & data analysis

Tools

TriZetto Facets

Job description

Key Responsibilities

• Work with functional knowledge of the claims lifecycle processing, including:
  • Claims adjudication
  • Fee schedules
  • RCM (Revenue Cycle Management)
  • Provider networks
  • Explanation of Benefits (EOB)
• Work within a TriZetto Facets environment, understanding how Facets outputs:
  • Claims data
  • Provider records
  • Financial extracts
• Work with healthcare EDI standards, specifically:
  • HIPAA EDI 837 Claims
  • EDI 835 Remittance Advice
  • EDI 834 – Enrolment
• Work with financial postings, including:
  • Debits/credits
  • Claims payments
  • Denials
  • Adjustments
• Work with ECC integrations.
• Work with payment and disbursement systems.
• Use ADO and test automation.
• Work with reporting and data analysis tools.

Required Skills