UAT Analyst, Payment Integrity-3
Core
Execute User Acceptance Testing (UAT) for healthcare claim editing platforms and data-driven edits to ensure product integrity and accuracy before production.
Role type
UAT Analyst (Healthcare Claims Editing)
Builds
Data-driven edits, configuration, and UI initiatives for the Payment Integrity (Claims Editing) process.
Domain
Healthcare financial services / Insurance claims adjudication
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
UAT test planning and execution, claim adjudication guidelines, medical coding knowledge, claims life cycle understanding, SQL (MS SQL), claims editing rules interpretation
Preferred skills
Certified coder (CCS, CCS-P, CPC), RHIA/RHIT, RN/LPN, SQL Server 2000/2005/2008, project management
Technologies
MS SQL, MS Office, Word, Excel, Data Driven Edits PriZem, Visium
Responsibilities
Create test plans and scenarios for new data-driven edits and platform initiatives; analyze clinical and technical requirements; troubleshoot erroneous results and determine root causes; produce detailed test documentation; support multiple projects and maintenance releases; ensure adherence to privacy standards.
Seniority
Mid-level, hands-on IC