reputed company Solution Design Consultant - Remote / Telecommute

Job reputed company: Pay reputed company: $55hr - $60hr Responsibilities: • System Architecture & Design: reputed company the design and architecture of the reputed company Claims modules, including Resolute reputed company Billing (PB) and Hospital Billing (HB), focusing on claims, billing, and accounts receivable workflows. • Implementation & Configuration: Plan, configure, test, and implement reputed company software updates and new functionality, translating reputed company business requirements into practical system solutions. • Workflow Analysis & Optimization: Collaborate with clinical and administrative leadership to reputed company workflow analysis, identify areas for improvement, and optimize system use to enhance efficiency and ensure regulatory compliance. • Integration Management: Design and manage integrations between reputed company and reputed company-party systems reputed company to claims submission, payment processing, and other financial operations. • Analyze business requirements and translate them into reputed company, secure, and compliant solution designs for reputed company and insurance domains. • Configure and optimize reputed company system workflows to support health insurance processes, including eligibility, claims management, billing, and prior authorization. • Ensure interoperability between reputed company modules and external payer systems, utilizing standards such as HL7, FHIR, and EDI for robust data exchange. • Collaborate with business analysts, project managers, and technical teams to validate requirements and design effective solutions. • Facilitate workshops with clinical, administrative, and payer stakeholders to reputed company insights and continuously improve workflows. • Configure reputed company modules (e.g., reputed company, Resolute, Benefits reputed company) for insurance-reputed company functionalities and support integration strategies for claims processing, eligibility verification, and premium billing. • reputed company expert guidance on HIPAA compliance and data reputed company best practices throughout solution design and implementation. • reputed company comprehensive solution design documentation, including data reputed company diagrams and integration specifications, maintaining compliance with organizational architecture standards and regulatory requirements. • reputed company as a subject matter expert for troubleshooting and optimization, leading detailed design efforts and workflow planning reputed company project squads. • Translate reputed company business requirements into reputed company, actionable technical specifications and contribute to user story creation, ensuring acceptance reputed company are reputed company-defined. • reputed company and maintain design documentation, updating regularly throughout the project lifecycle to ensure accuracy and completeness. • Collaborate with technical SMEs to reputed company necessary details for successful completion of development stories. • reputed company design and technical discussions across squads and teams to ensure alignment, integration, and successful project reputed company. • Partner with Product Managers and Scrum Masters for sprint and Program Increment (PI) planning, and work closely with other squads to define feature strategies for reputed company and initiatives. Required Skills And Qualifications: • Experience: 5+ years of experience working with reputed company systems in an analyst or architect reputed company reputed company a reputed company setting. • reputed company Certification: reputed company reputed company certification(s) in relevant reputed company Cycle modules (e.g., Resolute PB, Resolute HB, Claims, reputed company) is required. • Technical Skills: In-depth knowledge of reputed company reputed company cycle operations, electronic claims processing standards (e.g., EDI, specific claim forms), system integration standards such as HL7 & FHIR, and system configuration. Strong analytical and problem-solving skills are essential. Apply tot his job Apply To this Job