Coding Business Analyst, Associate

Department: Operations - Payment Integrity

Reports to: Supervisor, Operations

Location: Idlewild Ave, Tampa, FL 33634

Performs user acceptance testing of core processing, claim editing and related software delivered from Applications Development and/or external vendors. Creates test cases and test scenarios for all functional requirements. Works closely with business partners to define, research, correct, retest defects, and resolve test variances from the test plan. Performs post production monitoring. Researches and troubleshoots production issues. Delivers quality product to business partners in support of meeting organizational goals and objectives.

Essential Functions:

  • Works closely with internal business partners and/or vendors to interpret the test needs as requirements are being developed in order to ensure the standard of testing supports the business need.
  • Creates test cases and test scenarios in support of business functional requirements.
  • Executes each test case to identify defects prior to the delivery of software and/or edits in a production environment and actively participates in reviews and checkpoints.
  • Works with internal business partners and/or vendors to resolve defects identified during the testing cycle.
  • Assigns severity levels to each test issue discovered during the test cycle.
  • Responsible for capturing and documenting metrics in support of the user acceptance testing and recommends improvements.
  • Ensure adherence to quality processes and procedures.
  • Develops ad-hoc reports to conduct data analysis and validation.
  • Evaluates financial impact of implemented initiatives.
  • Performs other duties as assigned.
Candidate Education:
  • Required: High School or GED
Candidate Experience:
  • Required: 2 years of experience in claims processing and/or testing, along with strong analytics
  • Preferred: 1 year of experience in a healthcare environment
Candidate Skills:
  • Ability to multi-task

*LI-JC1

About us
Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored managed care services through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans to families, children, seniors and individuals with complex medical needs. WellCare is a Fortune 500 company, and in 2018, was recognized as a Fortune "World's Most Admired Company", ranking in the top five among the health insurance and managed care industry-a testament to the hard work and dedication of the company's nearly 9,000 associates who each day live WellCare's values and deliver on its mission to help its members live better, healthier lives. The company serves approximately 4.4 million members nationwide as of Dec. 31, 2017. For more information about WellCare, please visit the company's website at www.wellcare.com. EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.