Hello

This is Vinay from Dew Softech and I have an excellent job opportunity with
one of my clients. Please find the complete job description below and let
me know if you are interested in pursuing this opportunity any further

*Position:          FACETS UAT Tester*

*Location:          NY*

*Duration:          6+ months*

*Interview:         Phone*

* *

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.



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.



Creates and facilitates the use of detailed test plans and test claim
specifications for multiple areas encompassing any of the claims, benefit,
and/or provider systems from both a front and back end perspective.



6 years claims processing experience 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.



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.

• 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.



Meets established quality and quantity metrics.   Keeps current on claim
processing procedures and policies.

• Knowledge in reading and interpreting system coding.

• Expert knowledge of Health Plan Operations and understanding of its
operating teams and their functions.

• Fully understand end-to-end processing of all billing and claims systems
used within the Health Plan.

• Demonstrated skills in quality principles especially root cause analysis
and problem solving.

• Effective communicator



*Vinay Devulapally*

* *

Please check our jobs on *careers.dewsoftech.com*

*[image: US-logo-gif]*

*Ph: 302 918 6038*

*mailto:[email protected] <[email protected]>***

*877-DEW-9566 (F) *

*Please add my Gtalk ID: [email protected]  *

*www.dewsoftech.com*

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