QA Analyst(Healthcare (Medicaid/Medicare)

  • Salary

    $50 Per Hour

Experience

to Years

Posted On

Sep 04, 2022

Company

Walken Consulting

Travel Requirements

N/A

Job Overview

Required Skills

  • Communication skills
  • ACT
  • Data analysis
  • Billing
  • Defect tracking
  • Business development
  • CMS
  • FDA
  • CPT
  • HIPAA
  • Claims
  • HL7
  • Customer experience
  • Database QA
  • EDI
  • EHR
  • EMR
  • Forms
  • HIS
  • Health care
  • ICD-10
  • IT
  • IT architecture
  • Implementation
  • Insurance
  • Inventory management
  • Invoices
  • JSON
  • MITA
  • MMIS
  • Medicaid
  • Medical devices
  • Medicare
  • Nursing
  • OOP
  • Payments
  • Pharmaceutics
  • Purchasing
  • QA
  • Receiving
  • SDLC
  • Software
  • System implementation
  • Test management
  • Test methods
  • Transformation

Job Type

Contract - W2, Contract - Independent, Contract - Corp-to-Corp

Work Authorization

N/A

Location

Rockville, MD

Job Description

Required Skills:
•8+ years of experience in IT/US Healthcare Payor and/or Provider, Pharma, Medical Devices domains
•Experience to perform work for the federally required Medicaid Enterprise System implementation
•Has an understanding of CMS Standards and Conditions and Medicaid programs
•Experience on the Medicaid Systems and Solutions includes expertise in Medicaid Information Technology Architecture (MITA) Business, Information and Technical architectures
•Ability to work in a coordinated effort, aligning on roles and responsibilities in the MMIS team
•Experience in MMIS modules including - Requisitioning, Purchasing, Receiving, Inventory Management, Invoicing and EDI
•Experience in dealing with Dx, Px, CPT, ICD-10 code
•Hands-on reading Explanation of Benefits (EOB) to calculate Allowed amount, Contractual Obligation/Write-Off/Patient Responsibilities as part of Billing/Trackers
•Experience in understanding Healthcare plans designed by Insurance and their business flow with respect to Health Insurances (Co-Ordination of Benefits)
•Well versed with payments responsibilities in terms of Co-pay, Coins, Deductibles and OOP Max
•Experience in dealing with Electronic and Paper based claims generated as 831, 834, 837 etc. on HCFA-1500 (CMS-1500) & UB-04 Forms
•Well versed with US-FDA Compliances like HIPAA, Hi-Tech ACT, 21 CFR etc.
•Experience in HL7 message transformation, their validation with Json and ADT
•Must have excellent verbal and written communication skills
•Experience with EHR/EMR/HIS/Nursing-Clinical Data application
•Experience in database testing. Good to have knowledge on advanced analytic tools to perform data extract and query functions
•Perform quantitative and/or qualitative data analysis and share results with internal and external customers
•Experience on varied test management and defect management tool
•Experience in varied testing methodologies along with SDLC methodologies

Optional – Good to have
•Experience in assisting the Business Development team in assessing and proposing new solutions to prospective clients in the healthcare space
•Experience in Implementation of Healthcare products at client/customer location
 


Job ID: WC220074

  • Posted By

    Edward Jenner

Designation

Sr. Hr manager

Company

Walken Consulting

Last Login

Mar 29, 2023

Posted On

Sep 04, 2022


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