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Corporate Functions & Operations WellCare - Business Analyst Careers

Business Analyst - Senior - Coding Job

Full Job Title: Coding Business Analyst, Sr

Job Number: 1703210

Location: Tampa, FL

Date Posted: 7-13-2017

Department: Operations - Payment Integrity

Reports to: Sr. Manager Coding Integrity

Location: Remote

Leads all testing efforts, such as writing test plans / cases and test evaluations as well as any other delegated activity regarding the testing process and methodology and performs user acceptance testing of core processing, claim editing and related software. 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 / cases. Delivers quality product to Business Partners in support of meeting organizational goals and objectives inclusive of identifying process improvement opportunities and implementing changes. Provides support and guidance daily to the Business Partners in performing their assignments, monitoring the successful delivery and adherence to policies and procedures. Implements process and efficiency improvements in an effort to allow the testing team to perform additional testing as the department strategically targets other correspondence implementation efforts. Performs post production monitoring. Researches and troubleshoots production issues. Provides guidance and support for other team members to ensure that the testing methodologies are maintained and high-quality product is delivered into the work stream.

Essential Functions:
  • Acts as the first point of contact for Analysts dealing with day to day business issues and provides support for problem resolution.
  • Leads the analysis and QA test efforts for all WellCare claims editing projects.
  • Develops testing standards and ensures that the team adheres to the departmental standards, policies and procedures, templates, formats, guidelines, etc.
  • Gives guidance, review and sign-off on all testing deliverables when applicable, ensuring business requirements documentation and test plans are designed to meet the business needs.
  • Analyzes and implements testing process and efficiency improvements in order that the testing team improve productivity, while also maintaining a high-level of quality.
  • Works with the with internal Business Partners to interpret the test needs as requirements are being developed in order to ensure the standard of testing supports the business need.
  • Determines the types of testing that must be conducted (i.e. data validation, regression, etc.) and creates a comprehensive test plan that supports the business and technological solutions being delivered.
  • Creates test cases, test scenarios and scripts in support of business functional requirements and in a reusable state.
  • Executes each test case to identify and resolve defects prior to the delivery of software in a production environment and actively participates in reviews and checkpoints.
  • Assigns severity levels to each test issue discovered during the test cycle.
  • Tests data to ensure it complies with specifications and present sound recommendations through thorough analysis.
  • Responsible for capturing and documenting metrics in support of the user acceptance testing and recommends improvements.
  • Ensure adherence to quality processes and procedures.
  • Assess current testing processes; recommend and implement process improvements.
  • Participates in the formulation of project time estimates.
  • Develops ad-hoc reports to conduct data analysis and validation.
  • Evaluates financial impact of implemented initiatives.
  • Performs other duties as assigned.
Additional Responsibilities:Candidate Education:
  • Preferred A Bachelor's Degree in a related field in information systems or information technology or related field
Candidate Experience:
  • Required 5 years of experience in Strong analytics in claims processing/coding and/or testing, preferably in healthcare
  • Preferred 5 years of experience in Software and or edit testing, preferably healthcare
  • Required Other Experience in full software development life cycle methodology
  • Preferred Other Automated testing tool experience
  • Required Other Project Life-Cycle experience
  • Preferred Other Experienced in using Quality Center or similar tools
Candidate Skills:
  • Advanced Demonstrated written communication skills
  • Advanced Demonstrated interpersonal/verbal communication skills
  • Advanced Ability to analyze and interpret financial data in order to coordinate the preparation of financial records
  • Advanced Ability to work as part of a team
  • Advanced Ability to work independently
  • Advanced Ability to work in a fast paced environment with changing priorities
  • Advanced Demonstrated organizational skills
  • Advanced Demonstrated project management skills
  • Advanced Other Ability to remain calm under pressure
  • Advanced Other Ability to work overtime as required
  • Advanced Other Knowledge of the Healthcare industry, specifically Managed Healthcare
Licenses and Certifications:
A license in one of the following is required:
  • Preferred Other CTFL
Technical Skills:
  • Required Intermediate Microsoft Outlook
  • Required Intermediate Microsoft Word
  • Required Advanced Microsoft Excel
  • Required Advanced Microsoft Visio
  • Required Intermediate Microsoft PowerPoint
  • Required Intermediate Microsoft Access
  • Required Intermediate Other Knowledge of one or more of the following: SQL, Xcelys, CES, iHT
  • Preferred Intermediate Other Medical Billing and Coding
  • Preferred Intermediate Other Claim reimbursement methodologies

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Last Updated On: 12/9/2015