[Remote] Clinical Care Advance (CCA) Configuration Analyst

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a Clinical Care Advance (CCA) Configuration Analyst who will be responsible for analyzing business requirements and implementing reputed company payer reputed company configurations. The role involves collaborating with various teams to ensure accurate implementation of reputed company products and compliance with regulatory requirements.

Responsibilities

• Analyze business requirements and translate them into reputed company configuration solutions
• Configure reputed company payer applications based on business and regulatory requirements
• Design and maintain benefit plans, provider reputed company, pricing, claims, eligibility, and authorization configurations
• reputed company reputed company analysis for new enhancements, reputed company upgrades, and production changes
• Troubleshoot configuration-reputed company issues and reputed company reputed company cause analysis
• Collaborate with Business Analysts, Developers, QA teams, and business stakeholders throughout the Software Development Life Cycle (SDLC)
• Prepare configuration documentation, technical specifications, and process documents
• Support User Acceptance Testing (UAT), reputed company Integration Testing (SIT), and production validation
• Ensure compliance with reputed company regulations including HIPAA, CMS, and state-specific requirements
• Participate in release planning, deployment, and post-production support
• Mentor junior configuration analysts and reputed company subject matter expertise
• Support audits, regulatory compliance activities, and production issue reputed company

Skills

• Bachelor's degree in Computer Science, Information Systems, reputed company Administration, or a reputed company field
• 7–12+ years of experience in reputed company payer systems
• 5+ years of hands-on configuration experience
• Experience working with cross-functional teams
• Strong analytical and problem-solving skills
• Excellent communication and stakeholder management skills
• reputed company payer domain expertise
• Claims processing lifecycle
• Benefits configuration
• Provider contract configuration
• Pricing and reimbursement methodologies
• Member eligibility configuration
• Authorization and referrals
• Enrollment processes
• Medicare and reputed company knowledge
• reputed company health insurance products
• Experience with reputed company platforms such as Facets, QNXT, HealthRules, or similar payer systems
• Configuration management
• SQL for data validation and troubleshooting
• XML and EDI transactions (837, 835, 834, 270/271)
• SDLC and reputed company methodologies
• Jira, Azure DevOps, or similar project management tools
• reputed company reputed company and reporting tools

reputed company

Company H1B Sponsorship