Lead complex projects, develop presentations, and resolve problems. Utilize knowledge of Medicare Part A/B/D, EDI formats, and healthcare industry trends. 5+ years of experience required.
Key Highlights
Technical Skills Required
Benefits & Perks
Job Description
100% Remote
EDI Medicare Tester (Facets Provider)
Contract
Job Description:
Bachelor’s degree and 5 years of experience OR 9 years of experience in business testing, business analysis, process improvement, project management, business operations or relevant health care industry experience
* 3 years of experience leading with large and complex multi-million-dollar projects.
* Experience communicating with senior management from multiple divisions.
* Experience developing and delivering presentations.
* Problem resolution experience and skills.
* Knowledge of strategic planning techniques and industry trends
* Experience interpreting business and financial information
* Negotiations skills.
* Verbal and written communications skills including establishing working relationships across departments, preparing presentations to senior management, and establishing team environment.
* Organizational skills.
* Experience managing multiple complex projects successfully.
* Detail oriented.
* PC proficiency to include MS Office products
* Knowledge and/or experience with:
- · Medicare Part A/B/D
- · Provider workflows & Provider application - Symplr
- · EDI formats – 837 I&P, 276/277, 270/271, 278, 834
- · Member Enrollment – Elements application
- · Member Collaterals
- · Provider Credentialing – sCRED application
- · Claims Intake process
- · Claims Adjudication logic – FACETS application
- · EOB
- · Provider Payments – 835 remittance files & EOP
- · CMS reporting
- · SalesForce
- · Evolve/Broker
* Test case management tools such as Zephyr
* Agile tool such as Jira/Rally
* SQL
* Health insurance or healthcare industry experience with emphasis on Product/Sales knowledge
Preferred Required Job Qualifications:
* Proven strategic thinking and execution
* Ability to drive decisions, create optionality and determine impacts of options