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Healthcare Insurance BA (SME)
Damco Solutions
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Job Summary
Location
Plainsboro ,NJ 08536
Job Type
Contract
Visa
Any Valid Visa
Salary
PayRate
Qualification
BCA
Experience
2Years - 10Years
Posted
24 Dec 2024
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Job Description
10-12 years of
Health SME (Subject Matter Expert)
experience, Preferably in health care or health insurance industry
Health, Hospital/Wellness, Cancer,
Critical Illness,
MEC1-
Skinny Limited Medical,
MEC2
-Limited Medical,
MEC3
-Limited Medical products expertise is a must in US region.
Proven experience with u
nderwriting
processes,
policy admin s
ystems,
claims
process,
benefit configuration
, Form generation, and integrations with down and upstream systems.
Proven experience in implementing
Health portal
s following
ANSI EDI
standards.
Experience with
Health insurance
systems for carriers and
MGAs
Exposure to
Medicaid
and
Medicare
systems
Knowledge and Experience in
billing, Claims, HIPAA regulations, EDI files
Proficiency in requirements gathering, process modelling and documentation
Ability to collaborate with stakeholders at all levels internally and clients
Familiarity with industry specific tools for policy administration, claims management and underwriting
Experience in integration of core system with portals and apps.
Extensive experience in functional integration with associated third-party systems
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