|Job Location||Southfield, MI, USA|
|Job Length||Six Month to One Year|
|Other Required Skills||
• Experience with data entry of claim data – UB04 and/or HCFA
• Working knowledge of Claims Processing, Document Imaging and
Claims Data Entry Processes.
• Knowledge of NASCO CSR process
• Knowledge of claims processing - i.e. END on NPS and/or Legacy
• Working knowledge of NASCO claims systems applications – i.e.
eFDE, EEC, HIQK, suspend codes, GENO tables etc.
• Working knowledge of systems development life cycle phases and
• Experience working with end users to document operational and
Resource to perform the following functions:
• Input UB04 and CMS1500 claims data into the existing NASCO eFDE
• Working knowledge of 837 I, 837 P, and 837 D mapping as input
for Claims processing.
• Working knowledge of 835, 277CA, 999, and TA1 transactions.
• Working knowledge of HIPPA Transactions Compliance checking.
• Experience with modifying 837 transactions.
• Recognize and report keying/navigation defects.
• Develop test cases, scenarios, and scripts to ensure
• Participating with end user in testing proposed process and
• Documentation of test results, test strategies, test
• Responsible for detailed status reporting as well as attending
and participating in project meetings.
|Other Nice to Have Skills||
• Bachelor's degree with a preferred major in health
administration, business or related field preferred
• Minimum of 3-5 years of health care experience preferred.
• Experience developing and executing test scenarios for unit,
process, function, system integration, and acceptance testing.
• Experience developing and maintaining technical reference
• Knowledge of approaches, tools, techniques for testing and
• Ability to produce a variety of business documents that
demonstrate command of language, clarity of thought and
orderliness of presentation.
• Knowledge of BCBSM operating systems preferred.
• General understanding of project phases.
• Demonstrated excellent written and oral communication skills
• High proficiency with Microsoft Word and Excel required.
Successful completion of Microsoft Office Suite training
• Strong organizational and follow-through skills, and
particularly strong attention to detail required.
• Strong creative problem solving skills required.
• Demonstrated flexibility, self-discipline and ability to work
independently, as well as within a group, required.
• Ability to work effectively with multiple internal and external
• Ability to handle multiple tasks and implementation timeframes
• Ability to interact effectively with BCBSM representatives at
various levels required.
|Minimum Immigration Status||H1B Visa|
|Job Starting Date||July 6, 2016|
|Wage/Salary||Hourly: Depending On Experience|
The ideal candidate will develop, create, test, validate, and document claims data within the NPS and local BCBSM claims processing systems. Tasks/activities include, (but are not limited to):
1. Preparation of test data, i.e. - selecting the appropriate test claim(s) and corresponding transactions.
2. Claim data input/entry and processing.
3. Verification / validation test results.
4. Monitoring / tracking of test cases / test scenarios/defects/resolutions utilizing Clear Quest.
5. Interfacing with multiple project teams / workgroups to ensure all inclusive testing of processes, procedures and operations.
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