Client is seeking a skilled professional with strong expertise in HealthRules Payor (HealthEdge platform) and experience in Medicare benefits and claims. This role involves hands-on work with benefit configuration and claims testing, as well as collaborating closely with business stakeholders.

Responsibilities

• Utilize HealthRules Payor platform for benefit configuration and claims testing.
• Review business requirements, identify changes to benefits, and develop comprehensive test cases, scripts, and data for execution.
• Document the testing lifecycle, create a reusable repository, and identify opportunities for improvement or automation.
• Collaborate effectively with business teams and stakeholders to ensure alignment and clarity.

Requirements

• 4-5 years of experience with HealthRules Payor (HealthEdge platform).
• 4-5 years of hands-on experience with benefit configuration and claims testing.
• Strong domain knowledge in Medicare benefits and claims.
• Proficiency in developing exhaustive test cases, scripts, and data for benefit changes.
• Excellent documentation skills and ability to create reusable resources.
• Strong communication skills and collaborative experience with business stakeholders.