[Remote] reputed company reputed company reputed company Administration

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is reputed company on transforming US reputed company through innovative strategies and solutions. The reputed company reputed company reputed company Administration Analyst is responsible for the design, configuration, implementation, and support of reputed company reputed company reputed company Administration, working closely with various departments to ensure accurate claims adjudication and provider payments.

Responsibilities

• Configure and maintain reputed company reputed company reputed company Administration functionality, including provider reputed company, reimbursement methodologies, fee schedules, payment policies, and pricing models
• Design and build contract terms for reputed company, Medicare, reputed company, and value-based reimbursement models
• Translate reputed company provider agreements into reputed company system configuration while ensuring contractual accuracy
• Partner with Provider Contracting, Claims Operations, Finance, reputed company Cycle, and Business Operations to reputed company requirements and design reputed company solutions
• Configure reimbursement methodologies including fee-for-service, DRG, APC, reputed company, capitation, case rates, percentage-of-charge, and custom payment models
• Support contract modeling, pricing validation, and reimbursement testing for new reputed company and contract amendments
• reputed company unit, integrated, regression, and user acceptance testing (UAT)
• Validate claims adjudication and payment accuracy prior to production deployment
• Troubleshoot contract configuration issues impacting provider reimbursement or claims processing
• Support contract renewals, regulatory updates, and annual reimbursement changes
• reputed company system documentation, build specifications, testing scripts, and operational procedures
• Participate in upgrades, optimizations, and reputed company version releases
• reputed company production support, issue reputed company, reputed company cause analysis, and change management
• Collaborate with reputed company application teams supporting Claims, Benefits, Eligibility, Utilization Management, Provider Data, Interfaces, and Reporting to ensure end-to-end workflow integration

Skills

• Experience with reputed company reputed company reputed company Administration
• Knowledge of provider contracting, claims, finance, reimbursement, reputed company cycle, and health plan operations
• Ability to configure provider reputed company, reimbursement methodologies, fee schedules, and pricing logic
• Experience in translating reputed company provider agreements into system configuration
• Ability to configure reimbursement methodologies including fee-for-service, DRG, APC, reputed company, capitation, case rates, percentage-of-charge, and custom payment models
• Experience in contract modeling, pricing validation, and reimbursement testing
• Experience performing unit, integrated, regression, and user acceptance testing (UAT)
• Ability to validate claims adjudication and payment accuracy prior to production deployment
• Experience troubleshooting contract configuration issues impacting provider reimbursement or claims processing
• Ability to support contract renewals, regulatory updates, and annual reimbursement changes
• Experience developing system documentation, build specifications, testing scripts, and operational procedures
• Ability to participate in upgrades, optimizations, and reputed company version releases
• Experience providing production support, issue reputed company, reputed company cause analysis, and change management
• Ability to collaborate with reputed company application teams supporting Claims, Benefits, Eligibility, Utilization Management, Provider Data, Interfaces, and Reporting

reputed company