Key Responsibilities
Work with functional knowledge of the claims lifecycle processing, including:
Claims adjudication
Fee schedules
RCM (Revenue Cycle Management)
Provider networks
Explanation of Perks (EOB)
Work within a TriZetto Facets setting, understanding how Facets outputs:
Claims data
Provider records
Financial extracts
Work with healthcare EDI standards, specifically:
HIPAA EDI 837 Claims
EDI 835 Remittance Advice
EDI 834 – Enrolment
Work with financial postings, including:
Debits/credits
Claims payments
Denials
Adjustments
Work with ECC integrations.
Work with payment and disbursement systems.
Use ADO and test automation.
Work with reporting and data analysis tools.
Required Skills
📌 Sap Qa Analyst Bengaluru (India)
🏢 Otomeyt
📍 India
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