Hello Everyone,

Optum is hiring Consultant Business System at Noida location who can join us on short notice.

Primary Skills: Prospective Payment System (PPS), Payment System Interface (PSI), Easy Group, Rate Manager, Medicare, Medicaid, Commercial, DRG, APC, OCE, ESRD, CAH, CMG, RUG, RBRVS, UB04 and HCFA 1500 claim content

Experience: 6-9 yrs

Location: Noida

Notice period: Immediate to 45 days

Comfortable working in 3 PM IST Shift

Primary Responsibilities:

- PPS Client Support
- Ensures successful installation, implementation, and configuration
- Apply analytical / quantitative approach to problem solving
- Knows how to obtain and use data to support troubleshooting efforts
- Utilize communication skills to educate and inform
- Utilize ones solid interpersonal skills to work with all levels of management across all functional areas, as well as, business partners through internal entities
- Work within client ticketing system to track escalated issues, input new issues or answer issues sent in by other teams
- Communicate any responses back to client
- Implement changes as needed and outlined in contract
- Works directly with customers to define other project requirements, provide assistance to answer questions related to project results
- Assist as needed with other Reimbursement Solutions projects
- Engage with dedicated clients either VPN or Remote, WebEx to apply updates or Troubleshoot issues using software documentation
- Compile Documentation: Processes and Procedures (including but not limited to Clients specific tracking, network configuration,



rules of engagement)

Required Qualifications:

- Bachelor’s degree or equivalent work experience
- 6+ years or experience working in a healthcare data or regulatory workplace
- Experience with Prospective Payment System, Payment System Interface (PSI), Easy Group, Rate Manager
- Product support experience: configuring and customizing software solutions
- Experience with EasyGroup, Payment System Interface (PSI), Web.Strat and Rate Manager
- Experience pricing Medicare hospital facility claims (inpatient and outpatient)
- Experience breaking down information and developing solutions
Health plan experience in facility contract configuration, claims or IT
- Experience documenting client operational and technical workflow
- Experience configuring and customizing software solutions
- Some Facility claims reimbursement experience – Medicare, Medicaid, Commercial
- Expert knowledge and understanding of Prospective Payment Systems - includes DRG, APC, OCE, ESRD, CAH, CMG, RUG, RBRVS
- Regulatory knowledge of Medicare, Medicaid Payment Systems
- Proven exposure to healthcare claims data, basic PPS concepts, UB04 and HCFA 1500 claim content
- Comfortable to work in 3 PM shift
- Client facing role - Proven excellent communication

Preferred Qualifications:

- Experience with Microsoft Word, Excel, PowerPoint, Visio
- Some SQL experience
- NET or IIS
- Experience with Tableau
- Claims system knowledge – Trizetto Facets, Networx Pricer, QNXT, Health Rules Payer, IKA Claims, Burgess Systems, Epic Tapestry, 3M

📌 Consultant Business System Analyst (Noida)
🏢 Optum
📍 Noida