Quality Assurance Analyst (Health Edge, Health Rules Payer)

This Quality Assurance Analyst will be responsible for reviewing the Claims Processing Systems for configured benefits and reimbursement methodologies. Experienced candidates must demonstrate working understanding of claims processing systems and working knowledge of the health care industry. Scope Of Role & Responsibilities Create Test Scenarios and Test Cases based on requirementsQA Benefit and Provider Contract Configuration changes in claim systems to meet requirements and business needsCreate UB04 and CMS 1500 test claims aligning to requirementsMeet with business areas to gather business rules and requirementsMeet with Core configuration team to resolve defectsCreate and maintain documents related to QAAnalyze QA processes and recommend improvementsRun QA Automation processesPerform other QA tasks as needed Required Education, Training & Professional Experience A Baccalaureate Degree from an accredited college or university; andThree (3) years of progressive, responsible experience in QA involving test scenario and test case creation; andWorking knowledge of claims both UB04 and CMS1500; andWorking knowledge and expertise in IT applications and systems analysis methodology; andWorking knowledge of Managed Health Care MIS Systems; andWorking knowledge of QA automation tools; orA satisfactory equivalent combination of training, education, and experience Professional Competencies Integrity and TrustCustomer FocusFunctional/Technical skillsExcellent verbal and written communication skills.Excellent analytical ability.Excellent interpersonal, customer service and time management skills. #MPH50