- He/She will be the single point contact between the technology and operations team to receive and process a change request and implement the same.
- Responsible for Understanding the Customer Business (BRD) and Converting into Technical Requirement document.
- Responsible for reviewing the Test cases documents.
- Coordination with Operations UAT team for all the changes and Providing Support to complete the UAT testing.
- Make sure that all the Software Processes (SDLC) are followed for the project during the initial implementation as well as during the BAU stage.
- Manage the Client and Internal Communication with respect to Policy and Procedure changes and any other system changes/customization, during the BAU stage.
- Work with PE, SE (Process excellence, Service excellence) team and OPS team to continuously improve the Productivity and Quality of the services.
- Provide 24/7, Production support for the Software Systems. ( 2nd level )
- When an issue is generated, the He/She will check if the request has been approved by the PM of the project.
- He/She will then analyze the change request, makes sure that the issues are valid and identify whether the change required is a design change or enhancement or whether a new tool is to be developed.
- For analysis, he/she will take the help of project leaders involved in the project, both from the technology team and the operations team.
- If the requirement is a design change or if a new tool development that needs significant effort from the technology team then he/she will discuss with the management of the company on the feasibility, cost effectiveness, resource allocation plan and acquire the approval of the management before proceeding further.
- Once approved, he/she will draw the resource allocation plan after the identifying the resources for this project along with the PL of the Technology team.
- He/She will also monitor the progress of the change implementation from the analysis stage to the Issue closure stage and float the required communications to the appropriate people as and when necessary.
- He/She will ensure that the Acceptance team has accepted the enhancements before releasing the final product for production.
Knowledge, Skills and Abilities:
Required Knowledge:
- Knowledge on SQL
- Knowledge on other technologies like XAML, XML, XPATH, JSON
- Knowledge on US Healthcare Payer and Provider
- Knowledge on various EDI formats NSF, ANSI 837(I) , 837 (P), 835(D), 835, 275, 277, 999, 834 etc
- Knowledge on OCR Capabilities will be an added advantage
- Worked on a High end process called Benefit configuration which involves building, coding and maintenance of Health Insurance plans on the ACAS (Automatic Claims Adjudication System)
- Good Knowledge on Enrolment Services, Cash Posting, Patient Access Services, Eligibility Services, Medicare Advantage Plan, Receivables Management Services, Self-pay Cash Acceleration Services, Healthcare Collections Services, Front-end Assessments
- Good knowledge/experience in ICD, CPT, HCPCS, Dental codes, Provider contracts, Benefit Coding, Overpayment recovery, Quality Control Methods, EDI Transactions,HL7
- Interfaced with business users to prepare and update Business Process Requirements (BPR) and Software System Requirements (SSR)
- Good knowledge/experience on Revenue Cycle Management (RCM)
Skills Required:
- Consultative
- Socially confident
- Achievement oriented
- Decisive and action oriented
- Creative
- Eager to learn
- Resilient
- Business Foresight
- Influencing Others
- Fostering Partnerships With Customers
- Managing Transformation
- Driving Excellence
- Leading Teams
- Working Across Boundaries
- Strong analytical, conceptual and problem-solving abilities
- Interpersonal skills
- Problem solving skills
- Fast learning skill
- Result orientation
