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Job summary
Infojini Inc is looking for a Claims Processing Lead for a contract of over 2 months with potential for extension. You will act as the main point of contact for the Claims Processing workstream, working with stakeholders to gather data and document business requirements. Responsibilities include creating workflows, identifying gaps, and enhancing operations. A hybrid schedule is offered, and strong communication skills and experience in claims processing are essential.
Qualifications
Experience in claims processing or similar business operations.
Strong communication and liaison skills.
Proven ability to analyze workflows and identify improvements.
Responsibilities
Serve as the main point of contact for Claims Processing workstream.
Gather data and document business requirements with stakeholders.
Create inventory of current and future state workflows for claims processes.
Monitor progress and provide updates to stakeholders.
Skills
Stakeholder engagement
Business requirement documentation
Workflow analysis
Testing and validation
Training material development
Job description
Duration – 2+ months contract position, with the possibility of extension
Shift Time – Monday – Friday 9AM – 5PM
Hybrid Schedule
Position Overview:
Serve as the main point of contact for the Claims Processing workstream.
In partnership with our Consultant, interview stakeholders, gather data, and define/document business requirements while ensuring a comprehensive understanding of needs and objectives. This includes, but is not limited to, system configuration, workflows, reporting, and capacity plans.
Create an inventory of current state and future state workflows for all claims processes including downstream processes (reporting, data feeds, and other applications).
Identify any gaps in the current documentation of processes and partner with the Consultant on the creation of those.
Understand existing gaps and/or pain points within the Claims department and collaborate with the Consultant to identify solutions for improvement.
By working with the Consultant, identify industry best practices to enhance the claims operations and drive system improvements.
In partnership with the Consultant and Vice President of Claims Operations, confirm that the product roadmap includes all requirements for claims processing, the configuration/development work is prioritized appropriately, and all enhancements are identified based on business value.
Review all claims specific business requirements, workflow documentation, policies, and procedures created by the Consultant and confirm accuracy prior to sign off.
Collaborate with our QA teams and the Consultant to define all test cases, test scenarios, and acceptance criteria.
Assist in the testing and validation of all applications used by the Claims department against established requirements to ensure all test cases and scenarios pass.
During testing, identify deviations from requirements and partner with the Consultant to remedy all issues.
Contribute to the development of training materials that will be leveraged when conducting our formal training of team members.
Review all training materials created by the Consultant to confirm accuracy and quality of materials.
Monitor progress of the workstream and provide regular updates to stakeholders, addressing and escalating any changes in scope or roadblocks promptly.
Ensure timeliness of all deliverables outlined in the project schedule.
Act as a liaison between the Consultant, business stakeholders, development teams, and other critical resources, facilitating effective communication and alignment.
Other duties as assigned
Company Overview:
Infojini Consulting is a Staffing and Recruitment company and incorporated in Baltimore, MD.
Infojini caters various hospitals, health & wellness centers, pharmacy, and medical facilities over fifty states across the United States