Location: Norfolk, VA
Full time
Salary range: $100-130k/yr
Candidate must have Healthcare domain experience.
10+ years of Experience in Healthcare domain - Specially in Claims area
Strong in Functional & technical requirements related to Claims Adjudication cycle, Pricing & Pend Analysis
Extensive experience in Provider and Membership along with EDI/HIPAA transactions
Should have knowledge on End to End payer life cycle
Should have experience in Agile methodologies
Experience in creating use case, wireframe and requirement tracking using JIRA
Serve as functional lead/Business Analyst with other project team members on other systems that impact specific projects to ensure no adverse impact to the other systems
Monitor functional specifications and change requests to ensure project stays within scope and meets regulatory requirements
Schedule and facilitate project team meetings as applicable to ensure all team members are informed and issues are addressed
Participate in design discussions and document and deliver required functional specifications for application changes
Serve as subject matter expert to internal application owners and project members to consult and advise on how applications may be impacted by enterprise-wide initiatives
Participate in and document data mapping for integration of systems, conversion and acquisition related projects to understand how applications may need to change or be impacted by enterprise-wide initiatives, like regulatory requirements, other system enhancements or business initiatives
Determines operational objectives by understanding Facets systems; gathering information; evaluating output requirements and formats
Determines best and possible Automation solutions for the project for the migration projects
Improves systems by studying current practices; designing modifications and possible performance improvements
Defines project requirements by identifying project milestones, phases, and elements; forming project team.