Senior Medicare EDI Tester (Facets Provider) - 100% Remote

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