Technical Business Analyst (ITS Hosting Parallel Testing/HealthRules Payer (HRP)

This position is responsible for understanding stakeholder needs and business issues to be addressed in the Enrollment Applications. Collaborate with the Product owner to assess configuration, EDI Eligibility transactions data mapping, Open Enrollment process, Exchange (Affordable Care Act) processes. Understand Eligibility and Premium billing functions. Assess requirements associated with new input and output Eligibility feeds, define UAT scope/testing needs and validate results. Act as point of contact for release notes, requirements and test cases related to Open enrollment processes and enhancements. Work alongside business and technical teams to increase collaboration and optimize productivity and communication. Ensure requirements and solutions conform to departmental, corporate, industry and government standards as specified.
We are looking for a Claims Systems Technical Analyst that has hands on Testing experience that could run claims through the system for testing.
Healthcare Insurance experience on hand-on Claims Adjudication experience, configuration, and/or financial background - is a must

Responsibilities

Contribute to software development projects by writing, testing, and debugging code, with an emphasis on complex and critical components.

Collaborate with team members to meet project requirements, actively participating in design and code reviews.

Provide technical expertise and support to team efforts, acting as a subject matter expert in specific domains.

Assist in solving complex technical challenges, researching and proposing solutions.

Participate in defining software requirements and specifications.

Debug and troubleshoot production issues, working closely with operations and support teams.

Contribute to the assessment and adoption of new technologies and best practices.

Mentor junior team members, providing guidance and knowledge sharing.

Basic Qualifications:

Bachelor's degree in a relevant field (i.e., Computer Science) or equivalent combination of education and experience

Typically, 5+ years of relevant work experience in industry, with a minimum of 2 years in a similar role years of relevant software engineering experience

Proficiency in 1 or more software languages and development methodologies

Strong programming and debugging skills

Familiarity with software development practices and methodologies

Strong problem-solving skills

Good team collaboration and communication abilities

Willingness to take ownership of complex technical challenges

Skills

Must have

Essential Job Functions:

HealthRules Payer (HRP) Experience

Healthcare Insurance experience on-hand, Claims Adjudication experience, configuration, and/or financial background

TA/BA/QA experience in an Agile Methodology or Waterfall project planning

Hands-on Testing experience

EDI transactional knowledge and ability to update or audit values: 837 and 835

Explanation of Payment knowledge/history, Financial or offset knowledge

HRP XML transaction knowledge

ITS system knowledge (Bluecard)

Nice to have

Great communication skills

Other

Languages

English: C2 Proficient

Seniority

Senior