*Position: QA Analyst with Facets Exp :: [REMOTE Position]Location: East Rochester, NY.Duration: 3-6+ Month contract plus extension*
*Interview mode: Phone than Skype.Remote Position:: Work from HomeJob Description:*Reviews, interprets, and analyzes system documentation to ensure quality testing. Creates and executes thorough test plans and test cases needed to ensure all system changes and enhancements are implemented properly. Uses structured analysis and data management techniques to define appropriate test cases and ensure that quality project deliverables are achieved within the established time frames. *Essential Responsibilities/Accountabilities* • Analyzes, reviews, and interprets system documentation to ensure quality testing. • Coordinates data collection and analysis for creating and modifying test plans of a single business system from both front and back end perspective • Performs system testing development and coordinates implementation activities. • Conducts interviews and other data gathering activities. • Ensures appropriate testing with other areas. • Coordinates the review of test results to ensure compliance with process specifications. • Participates in analysis, research, and resolution of Health Plan business system issues. • Accountable for meeting established quality and quantity metrics. • Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies mission and values and adhering to the Corporate Code of Conduct. • Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. • Regular and reliable attendance is required. • Performs other functions as assigned by management. • Creates and facilitates the use of detailed test plans and test claim specifications for multiple business or provider systems from both front and back end perspective. • Reviews project and system documentation for completeness, quality, and operational impact. • Prepares reports for quality results. • Coordinates external department projects with IT and other internal and external departments within the Health Plan • Reports project status and issues to senior level management • Interfaces with vendors and other outside sources, as needed *Minimum Qualifications* • Bachelors degree and a minimum of *4 years claims processing experience required*. In lieu of degree, 10 years related experience or equivalent combination of education and experience in related field required. • Maintains familiarity with the latest techniques for project analysis, testing and implementation of projects. • Experience in structured analysis, design and test data gathering techniques required. • Extensive knowledge of reimbursement methodologies/benefit design and contract language (member and provider). • Experience with any combination of the following LRSP/TOPS, TOPPS, CAPS, UWIN or ICPS *and iFacets applications required*. Required to have experience in at least two of these claims systems. • Open Enrollment experience • Experience testing benefits, benefit grids *• IBM Rational Suite experience* • SQL querying exp is preferred • Ability to propose business strategies to assist in meeting the process improvement goals set by the Corporation. • Knowledge of provider billing practices including national coding schemes such as CPT-4, Revenue, HCPC, and ICD-9. • Strong analytical and problem solving skills. • Ability to identify root causes of business and/or workflow problems and determine innovative sources for solutions and opportunities. • Must have solid communication skills both oral and written. • Knowledge in Federal and State benefit regulations/mandates. • Meets established quality and quantity metrics • Keeps current on Federal, NYS and Department of Health benefit mandates and regulations • Keeps current on claim processing procedures and policies. • Knowledge in reading and interpreting system coding. Thanks Regards *Steven Olson* (Technical Lead) *Ennovace Inc* Ph: 214 541 9081 F: 972-262-9006 [email protected] www.ennovace.com 1801 S O'connor Rd Irving TX 75061 Disclaimer: We respect your Online Privacy. This e-mail message, including any attachments, is for the sole use of the intendedrecipient(s) and may contain confidential and privileged information.Any unauthorized review, use,disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. If you are not interested in receiving our e-mails then please reply with a "REMOVE" in the subject line at [email protected] and mention all the e-mail addresses to be removed with any e-mail addresses, which might be diverting the e-mails to you. We are sorry for the inconvenience. -- You received this message because you are subscribed to the Google Groups "Open Source Erp & Crm" group. 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