Benefit Configuration and Testing Specialist

Job description

**Job Summary:** We are seeking a skilled HealthRules Payor Senior Executive tester to perform testing on Cotiviti edits and support configurator to perform testing on HealthRules Payor setups. The role involves supporting & testing changes in Cotiviti Rules, working on Cotiviti tool triggers and procedures, ensuring timely updates and maintenance. Strong analytical skills, Testing knowledge and effective communication. **Key Responsibilities:** · Possess knowledge in testing & claim processing including Cotiviti rules & triggers (FRE, UNB, MUE, non-covered, bundled scenarios) and knowledge in different products, member accounts and contracts. · Execute and manage end-to-end testing cycle for Cotiviti in HRP. · Analyze and test to maintain HealthRules Payor, supporting changes in Quarterly CMS dictionary Updates and procedures. · Create comprehensive test plans and test cases based on project requirements and specifications. · Perform testing based on Cotiviti & CXT rule changes and implementation. · Work with the HealthRules Payor (HRP) application, Cotiviti Tool. · Perform full, unit, and regression testing. **Skills/Experience:** · Strong analytical skills and having knowledge about quarterly CMS dictionary updates. · Testing skills (test scenario creation, test runner tool handling, QA). · Good Knowledge in Cotiviti & CXT Tool. · Excellent communication skills. · Ability to work independently and as part of a team. · Knowledge of HIPAA regulations and compliance in healthcare data management. · Strong knowledge on CPT, ICD Codes, HCPCS. **Candidate Profile:** Education/Qualification: Any Graduate **Work Experience:** 3 - 5 years of experience in US health insurance domain and claim testing and At least 2 years of experience working with HRP applications and minimum 1 year of experience in working with Cotiviti tool. **Functional Skills:** US Healthcare Benefits, Testing skills on HRP, knowledge in Cotiviti tool. · Location – PAN India, · Experience – 3 to 5 Years · Work Mode – WFH · Target Company – NTT Data, HGS