Remote
C2C
susan_khan@aesincus.com
Rate : $55/hr.
Must have skills: Medical Claims Adjudication|
- Electronic Health Records (EHR) and Electronic Medical Records (EMR) systems.
- Comprehensive understanding of
Responsibilities
Years of Experience: 10 15 Years
Key Experience:
- Strong knowledge and hands-on experience in Medical Claims Adjudication across multiple payers.
- Experience creating functional requirements documentation such as BRDs (Business Requirements Documents) and DSDs (Design Specification Documents).
- Experience configuring claims-related business rules based on policy, business, and technical requirements.
- Strong Healthcare domain experience is mandatory.
- Hands-on experience working with Electronic Health Records (EHR) and Electronic Medical Records (EMR) systems.
- Comprehensive understanding of healthcare business processes, payer-provider workflows, claims processing, and regulatory requirements.
Additional Experience:
- 2 to 5 years of experience as a Business Analyst, Systems Analyst, or related role working with information technology and business teams.
- Bachelor’s degree in a technical or business discipline, or an equivalent combination of education and experience.
- Intermediate knowledge of requirements gathering, documentation, analysis, validation, traceability, prioritization, and change management.
- Ability to translate high-level business requirements into detailed functional and technical requirements.
- Experience with Long-Term Care (LTC), Inpatient, and Outpatient claims processing.
- Strong stakeholder management, communication, and client-facing skills.
Preferred Candidate Profile:
- Extensive experience in the Healthcare industry, with expertise in EHR/EMR platforms, Medical Claims Adjudication, and Claims Processing.
- Proven ability to gather business requirements, create detailed documentation, and work effectively with business and technical teams to deliver healthcare technology solutions.