Note: The job is a remote job and is open to candidates in USA. MetroPlusHealth is seeking a Quality Assurance Analyst who will be responsible for reviewing the Claims Processing Systems for configured benefits and reimbursement methodologies. This role involves creating test scenarios and cases, analyzing QA processes, and running QA automation processes.
Responsibilities
- Create Test Scenarios and Test Cases based on requirements
- QA Benefit and Provider Contract Configuration changes in claim systems to meet requirements and business needs
- Create UB04 and CMS 1500 test claims aligning to requirements
- Meet with business areas to gather business rules and requirements
- Meet with Core configuration team to resolve defects
- Create and maintain documents related to QA
- Analyze QA processes and recommend improvements
- Run QA Automation processes
- Perform other QA tasks as needed
Skills
- A Baccalaureate Degree from an accredited college or university
- Three (3) years of progressive, responsible experience in QA involving test scenario and test case creation
- Working knowledge of claims both UB04 and CMS1500
- Working knowledge and expertise in IT applications and systems analysis methodology
- Working knowledge of Managed Health Care MIS Systems
- Working knowledge of QA automation tools
- A satisfactory equivalent combination of training, education, and experience
- Integrity and Trust
- Customer Focus
- Functional/Technical skills
- Excellent verbal and written communication skills
- Excellent analytical ability
- Excellent interpersonal, customer service and time management skills
Company Overview
MetroPlusHealth provides health insurance to individuals, families, and small businesses. It was founded in 1985, and is headquartered in New York, New York, USA, with a workforce of 1001-5000 employees. Its website is https://www.metroplus.org/.