Associate Quality Analyst
About The Position
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Data Analyst role requires a highly flexible and adaptable candidate with the ability to handle periods of stress and/or heavy workloads. The ability to adeptly navigate ever changing priorities is also a key skill of the Data Analyst position. The Data Analyst primarily works independently, however, is also expected to work collaboratively across teams and the organization to support our client’s needs and meet their affordability goals. Job responsibilities include performing Integrated System Testing activities. Develop claim scenarios to test CES facility and physician edits, as well as maintain the existing test suite of claims. You will enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.
Requirements
- High School Diploma/GED
- 2+ years of claims processing experience or equivalent knowledge
- 1+ years of reimbursement policy experience
Nice To Haves
- 5+ years of healthcare reimbursement experience
- 6+ months of specific CES claim editing experience
- 2+ years of user acceptance testing experience
- Strong analytic, technical, and problem-solving skills
- CPC or other coding certification
Responsibilities
- Develop and implement effective physician and/or facility claim scenarios that test updates and change initiatives for all standard, customized, and repricing templates
- Maintain a robust test suite of physician and facility claims for effective and efficient testing of edits for all lines of business
- Collaborate with internal and external business partners to identify and remediate defects within edits
- Actively participate in cross-team meetings to support the client’s requests
- Apply Quality Assurance audit results for future integration and system development and testing
- Identify process improvement opportunities and actively participate in process improvement teams
- Ensure completion of assigned tasks by posted deadlines
- Participate in new hire training and work with mentors
- Support post deployment validation
- Comply with the Software Development Lifecycle (SDLC) and agile Methodologies
- Understand Testing, Stage and production environment concepts
- Establish the right strategies for Test Data
- Adhere to compliance checks, e.g., HIPPA, Quality control guidelines and practices
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
