EI
Medicare SME- Payment Integrity Analyst
Expert In Recruitment Solutions
🇺🇸 United States
On-site
6 months ago
- CMS
- End-to-End Testing
6 months ago
Not enough detail in this posting to match
Duration: 12 months
Location: Remote
- This resource will implement a process to test end-to-end common Medicare Advantage leakage scenarios across multiple Medicare service categories to rapidly determine whether any common issues are relevant at Client NC.
- TriZetto Facets configuration experience is required
- Collaborate with the team to establish rapid methods to identify current Configuration and payment leakage across key Medicare service categories, and define what is needed to remediate issues quickly across the inputs that support claims payment (medical policy, authorization, benefits, CMS rules, reimbursement policy, provider contracts, fee schedules)
- Support the following: Complete up-front end-to-end testing to identify leakage requiring remediation, and rapidly determine what is needed to implement fixes, including documentation, implementation, and validation testing.
Medicare SME- Payment Integrity Analyst · Expert In Recruitment Solutions