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data engineering · healthcare claims auditing

Health Benefits Systems Analyst

Delhi NCRPosted 2 months ago
Computer Systems AnalysisMid-levelFull Time; Regular
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As a skilled HealthRules Payor Configuration Specialist, you will be responsible for designing, developing, configuring, and testing HealthRules Payor configurations, including benefits, products, and policies. Your role will involve supporting changes in benefits, policies, and procedures, ensuring timely maintenance and updates of configurations. Key Responsibilities: - Possess knowledge in benefits, including benefit plans, templates, products, and accounts. Gather requirements, design documents, configure settings, and perform different types of testing (Dental, QA, and Regression) in HealthRules. - Analyze, configure, and test to maintain HealthRules Payor, supporting changes in benefits, contracts, and procedures. - Work with the HealthRules Payor (HRP) application, specifically Designer and Manager. - Utilize the Test Runner tool for creating UTCs and evaluating test results. - Understand and analyze healthcare eligibility and claims data flow within HealthRules. Write HRL (HealthRules Language) in HealthRules Payor applications. - Perform full, unit, and regression testing. Create demo documents to capture before and after configuration updates. - Communicate clearly and effectively with diverse audiences, including technical and non-technical personnel. Skills/Experience: - Strong analytical and problem-solving skills. - Excellent communication skills. Ability to work independently and as part of a team. - Attention to detail and strong organizational skills. - Basic knowledge of databases and SQL. Education/Qualification: - Any Graduate Work Experience: - 3-8 years of experience in US health insurance benefit configuration and testing. - At least 3 years of experience working with HRP applications. Functional Skills: - US Healthcare Benefits and Pricing configuration and testing. Location: - PAN India Shift: - 5PM - 2AM Work Type: - Hybrid As a skilled HealthRules Payor Configuration Specialist, you will be responsible for designing, developing, configuring, and testing HealthRules Payor configurations, including benefits, products, and policies. Your role will involve supporting changes in benefits, policies, and procedures, ensuring timely maintenance and updates of configurations. Key Responsibilities: - Possess knowledge in benefits, including benefit plans, templates, products, and accounts. Gather requirements, design documents, configure settings, and perform different types of testing (Dental, QA, and Regression) in HealthRules. - Analyze, configure, and test to maintain HealthRules Payor, supporting changes in benefits, contracts, and procedures. - Work with the HealthRules Payor (HRP) application, specifically Designer and Manager. - Utilize the Test Runner tool for creating UTCs and evaluating test results. - Understand and analyze healthcare eligibility and claims data flow within HealthRules. Write HRL (HealthRules Language) in HealthRules Payor applications. - Perform full, unit, and regression testing. Create demo documents to capture before and after configuration updates. - Communicate clearly and effectively with diverse audiences, including technical and non-technical personnel. Skills/Experience: - Strong analytical and problem-solving skills. - Excellent communication skills. Ability to work independently and as part of a team. - Attention to detail and strong organizational skills. - Basic knowledge of databases and SQL. Education/Qualification: - Any Graduate Work Experience: - 3-8 years of experience in US health insurance benefit configuration and testing. - At least 3 years of experience working with HRP applications. Functional Skills: - US Healthcare Benefits and Pricing configuration and testing. Location: - PAN India Shift: - 5PM - 2AM Work Type: - Hybrid

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