NOTE: This is a hybrid role which requires 1 day onsite per week (Client may be flexible for REMOTE for right candidate)
· Responsible for the delivery of major health care payer Policy Change Requests.
· Business requirement assessment, detailed system analysis, benefit designs and testing.
· Strong medical and facility claims background, understanding of the billing process, ICD codes, procedure codes, diagnosis codes.
· Strong knowledge of medical claims benefits processing.
· Detailed knowledge of medical, dental, vision, and hearing benefits.
· NASCO 3270 Mainframe experience.
· Working knowledge of identifying and implementing Medical Policy on NPS
· BFM/BFAST benefit configuration experience – analysis, testing, configuration, documentation, and all quality processes.
· Working knowledge of SharePoint.
