Job Description

The Claims Systems Lead Analyst position is the SME for the Claims Systems and suite of Claims Products. Within their SME role, the CSA will provide support to Claims Systems Analysts and other internal departments, as well as, external clients and vendors.

This position will be the primary associate for new product, or complex (multi-product and/or multi-state) claims systems client implementations and internal integration/migration efforts, as well as, change requests, design documentation creation and/or approval, and support the Claims Systems Director in production release approvals.

Responsibilities related include:

Define business, technical and claim data exchange requirements, instruct on data file mapping (such as provider, member, authorizations, claims, etc.), designing solutions and system configuration, creating test/use cases, SI testing, and providing support for associated UA testing, as related to their SME role, to ensure proper interaction for current and future claims product use.

The associate will be responsible for collaboration and oral/written communication with internal and external client business operations, IT departments and QA departments to support these requirements.

Additional responsibilities may include reporting development, RFP data processing requests, training, maintenance transition and process/product workflow/documentation.

This associate will perform duties under self-direction and have decision making responsibilities.

* Assist with pulling business requirements

* Hybrid of understanding business and technical sides of system

* Utilizing SQL to pull data through database

* Claims configuration through access database

* Loading claims files into system

* Background MC400 preferrable to make transition easier

* Will be conducting UAT/validation testing, end to end testing, other variety of testing for project.

* Extensive testing will be done through coordinating with other members of systems team

* Utilize Azure/DevOps to track project

* Document and outline testing within Excel

* Understanding of configuration and data analytical processes within system

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com .

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Skills and Requirements

5-10 years of healthcare claims life cycle experience, emphasis in claims system requirements analysis and configuration design

Access Database experience

SQL skills

UAT and validation testing experience

Experience gathering requirements from the business and translating into technical specs MC400

Bachelor's degree in business, healthcare or computer related field

Experience with ADO null

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion,sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military oruniformed service member status, or any other status or characteristic protected by applicable laws, regulations, andordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to HR@insightglobal.com.