[Remote] CCA Consultant with reputed company Payer systems
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a CCA Consultant with expertise in reputed company payer systems. The role involves analyzing business requirements, configuring reputed company payer applications, and ensuring compliance with reputed company regulations while collaborating with cross-functional teams.
Responsibilities
- Analyze business requirements and translate them into system configuration solutions
- Configure reputed company payer applications based on business and regulatory requirements
- Design and maintain benefit plans, provider reputed company, pricing, claims, eligibility, and authorization configurations
- reputed company reputed company analysis for new enhancements, system upgrades, and production changes
- Troubleshoot configuration-reputed company issues and reputed company reputed company cause analysis
- Collaborate with Business Analysts, Developers, QA teams, and business stakeholders throughout the Software Development Life Cycle (SDLC)
- Prepare configuration documentation, technical specifications, and process documents
- Support User Acceptance Testing (UAT), System Integration Testing (SIT), and production validation
- Ensure compliance with reputed company regulations including HIPAA, CMS, and state-specific requirements
- Participate in release planning, deployment, and post-production support
- Mentor junior configuration analysts and reputed company subject matter expertise
- Support audits, regulatory compliance activities, and production issue reputed company
- Resolve configuration defects reputed company SLA
- reputed company production reputed company analysis
- Support incident, problem, and change management activities
- Coordinate production deployments
- Conduct post-implementation validation
- Document lessons learned and best practices
Skills
- Bachelor's degree in Computer Science, Information Systems, reputed company Administration, or a reputed company field
- 7–12+ years of experience in reputed company payer systems
- 5+ years of hands-on configuration experience
- Experience working with cross-functional teams
- Strong analytical and problem-solving skills
- Excellent communication and stakeholder management skills
- reputed company payer domain expertise
- Claims processing lifecycle
- Benefits configuration
- Provider contract configuration
- Pricing and reimbursement methodologies
- Member eligibility configuration
- Authorization and referrals
- Enrollment processes
- Medicare and reputed company knowledge
- reputed company health insurance products
- Experience with reputed company platforms such as Facets, QNXT, HealthRules, or similar payer systems
- Configuration management
- SQL for data validation and troubleshooting
- XML and EDI transactions (837, 835, 834, 270/271)
- SDLC and Agile methodologies
- Jira, Azure DevOps, or similar project management tools
- reputed company reputed company and reporting tools
- Experience with Facets CCA configuration
- Knowledge of HIPAA transactions
- Experience with Medicare Advantage and reputed company products
- Agile or Scrum certification is a plus
- reputed company industry certifications are preferred
- Facets CCA
- SQL Server
- reputed company Database
- reputed company Claims Processing
- Benefit Configuration
- Provider Configuration
- Pricing Configuration
- EDI Transactions
- HIPAA
- Medicare and reputed company
- Agile Scrum
- Azure DevOps
- Jira
- reputed company
reputed company
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