Benefit Coding Consultant

Confidential Company  •  Pittsburgh, PA

Less than 5 years experience  •  IT Consulting/Services

Posted on 10/07/17 by Cynet Sytems
Confidential Company
Pittsburgh, PA
Less than 5 years experience
IT Consulting/Services
Posted on 10/07/17 Cynet Sytems

We are looking for Benefit Coding Consultant for our client in Pittsburgh, PA

Job Title: Benefit Coding Consultant

Job Location: Pittsburgh, PA

Job Type: Contract – 12 Months / Contract to Hire / Direct Hire

Job Description:

  • Accountable for identification, documentation and escalation of risks, defects and issues throughout the project lifecycle.
  • Responsible for assisting in the resolution of risks, defects and issues.
  • Responsible for verification that the code meets the customer needs based on the specifications, ensuring minimal defects in both UAT and production.
  • Research claims processing problems, perform initial problem identification and resolution activities and debug benefits and medical policy program coding. Document the results of problem analysis/research and prepare the specifications necessary to identify impacted claims.
  • Provide assistance on development of project deliverables - e.g. vision documents, business requirements, use cases, supplemental specifications, user design, testing plan, testing schedule, testing scenarios, testing outcomes, approvals, and training materials.
  • Manage job tasks and project requirements so that work is completed on time, in scope, within budget, and with minimal defects.
  • Follow coding structured protocols and maintain coding documentation. Perform system testing for coding group and production applications.
  • Assist in development of testing plan, scenarios, documentation and defect management to ensure minimal production defects are realized.
  • Complete analysis of the results tying back to customer impacts.
  • Interface closely with the business and technical staff during all phases of a project, including unit and system testing, integration and UAT testing culminating with implementation checkout and post implementation support

Perform root cause analysis and coding implementation to include:

  • Testing
  • Data clean-up
  • Business procedures implementation (suspense correction)
  • Business/Technical sign-off on CRs and projects
  • Other duties as assigned or requested.

General Experience:

  • Minimum Qualification: Graduate in any discipline
  • Minimum of 2+ years of relevant and progressive experience in Benefit Coding
  • Strong written and oral communication skills.
  • Strong relationship building skills.
  • Client focused with strong business acumen.
  • Self-starter with the ability to work under pressure independently and as part of a team.
  • Ability to think strategically and act proactively to create strong trust and confidence with business units. 
  • Strong innovative problem-solving capabilities.
  • Highly accountable and accepts constructive criticism effectively.
  • PreferredQualifications: Bachelor's Degree in Information Systems or Computer Science

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