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Claims Audit Analyst
Status:
Full Time, Employee
Relevant Work Experience:
2+ to 5 Years
Education Level:
Bachelor's Degree
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Location:
Boston, MA
Job Category:
Accounting/Finance/Insurance
Career Level:
Experienced (Non-Manager)
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Job Description
Overview:
Neighborhood Health Plan (NHP), located in Boston, is currently seeking an experienced, highly skilled Claims Audit Analyst.
Reporting to the Business Testing Supervisor under the direction of the Manager of Business Process Improvement, the Claims Audit Analyst will be responsible for performing all User Acceptance Testing including but not limited to: System Enhancements and Upgrades to NHP's integrated payment system, QNXT; data exchanges with external vendors; reports; and other software applications as required.
Responsibilities:
- Work collaboratively with stake holders to develop test scripts.
- Execute test plan and document test results, to ensure stability of changes.
- Create and maintain detailed test plans and issues logs.
- Provide status reporting to Supervisor.
- Be able to communicate with middle and upper management.
- Troubleshoot, determine business impact, resolve or escalate issues resulting from failed tests.
- Work with other business units such as the Configuration, Claims, and Provider Relations, to facilitate completion of testing activities as needed.
Qualifications:
- Bachelor's degree required
- Strong knowledge of health care/managed care operations (including claims, member services, contracting payment methodology, information technology)
- CPT, ICD-9, HCPC coding knowledge
- Three - five years of healthcare Use Acceptance Testing (UAT)
- Strong knowledge and advanced ability in Microsoft Excel
- Knowledge of Financial transactions
- Trizetto's QNXT, McKesson Claim check Knowledge is a plus
- Good Organization Skills
- Ability to multi-task
- Experience with using Microsoft Office (especially Excel)
- Must be self-motivated, detail oriented, and able to work independently in a dynamic environment
- Ability to meet required timelines, and maintain professional demeanor
NHP offers competitive salaries and an excellent flexible benefits package that includes medical, dental and vision insurance, generous earned time, commuter benefit, and a 401(k) employer contributed retirement program.
To apply please visit: www.nhp.org
NHP's mission targets a diverse population and our employees are just as diverse. As an equal opportunity employer, NHP recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives, and backgrounds.
Apply for this job online
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