Claims Technical Business Analyst
@ Jobs via Dice

Hybrid
$120,000
Hybrid
Full Time
Posted 1 day ago

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XXXXXXXXXX XXXXXXXXXXX XXXXXXXXX******* @pamten.com
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Job Details

Overview

PamTen Inc, presented via Dice, is seeking a Claims Technical Business Analyst to work on Enrollment Applications. In this role, you will work closely with the product owner, technical teams, and stakeholders to address business challenges in Open Enrollment processes and improve claims testing procedures.

Project Description

The position involves understanding stakeholder needs, mapping EDI Eligibility transactions data, and assessing requirements for new input and output Eligibility feeds. You will define the UAT scope and validate results. This role acts as the point of contact for release notes, requirements, and test cases related to Open Enrollment enhancements.

Responsibilities

  • Work with business and technical teams to optimize communication.
  • Ensure compliance with departmental, corporate, industry, and government standards.
  • Participate in design and code reviews while mentoring junior team members.
  • Run claims through testing procedures and troubleshoot production issues.
  • Analyze and resolve complex technical challenges.

Skills & Qualifications

Candidate must have hands-on testing experience with HRP Claims and a sound background in Healthcare Insurance claims. Familiarity with Agile or Waterfall methodologies along with a solid programming and debugging skill set is required.

  • Experience with HealthRules Payer (HRP) and Healthcare Insurance claims.
  • Understanding of EDI transactional flows, such as 837 and 835.
  • Experience with XML transactions and ITS Systems is a plus.
  • Bachelor's degree or equivalent technical experience.
  • Typically 5+ years in the industry with at least 2 years in a similar role.

Key skills/competency

Claims, Testing, HRP, Agile, EDI, Enrollment, Debugging, UAT, Healthcare, Analysis

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How to Get Hired at Jobs via Dice

🎯 Tips for Getting Hired

  • Research PamTen Inc's culture: Study their mission, values, and recent projects.
  • Customize your resume: Highlight claims testing and HRP experience.
  • Prepare detailed examples: Share Agile project experiences in interviews.
  • Practice technical interviews: Focus on debugging and data mapping processes.

📝 Interview Preparation Advice

Technical Preparation

Review HRP Claims testing processes.
Practice EDI mapping and data troubleshooting.
Familiarize with Agile and Waterfall practices.
Brush up on debugging and code analysis.

Behavioral Questions

Describe a challenging claims system test scenario.
Explain how you handle project miscommunications.
Detail a time when you led a team review.
Share an experience of meeting tight deadlines.

Frequently Asked Questions