Quality Assurance Analyst

Summary

MetroPlusHealth is seeking a Quality Assurance Analyst to join their Information Technology department. The role involves reviewing Claims Processing Systems and ensuring compliance with configured benefits and reimbursement methodologies, alongside creating and maintaining QA documentation and processes.

Responsibilities

• Create Test Scenarios and Test Cases based on requirements
• QA Benefit and Provider Contract Configuration changes in claim systems to meet requirements and business needs
• Create UB04 and CMS 1500 test claims aligning to requirements
• Meet with business areas to gather business rules and requirements
• Meet with Core configuration team to resolve defects
• Create and maintain documents related to QA
• Analyze QA processes and recommend improvements
• Run QA Automation processes
• Perform other QA tasks as needed

Skills

• A Baccalaureate Degree from an accredited college or university
• Three (3) years of progressive, responsible experience in QA involving test scenario and test case creation
• Working knowledge of claims both UB04 and CMS1500
• Working knowledge and expertise in IT applications and systems analysis methodology
• Working knowledge of Managed Health Care MIS Systems
• Working knowledge of QA automation tools
• A satisfactory equivalent combination of training, education, and experience
• Integrity and Trust
• Customer Focus
• Functional/Technical skills
• Excellent verbal and written communication skills
• Excellent analytical ability
• Excellent interpersonal, customer service and time management skills

Qualifications

Must Haves

• A Baccalaureate Degree from an accredited college or university
• Three (3) years of progressive, responsible experience in QA involving test scenario and test case creation
• Working knowledge of claims both UB04 and CMS1500
• Working knowledge and expertise in IT applications and systems analysis methodology
• Working knowledge of Managed Health Care MIS Systems
• Working knowledge of QA automation tools
• A satisfactory equivalent combination of training, education, and experience
• Integrity and Trust
• Customer Focus
• Functional/Technical skills
• Excellent verbal and written communication skills
• Excellent analytical ability
• Excellent interpersonal, customer service and time management skills