• Location: USA, Virginia, Glen Allen
  • Salary: Negotiable
  • Technology: Oracle Jobs
  • Job Type: Permanent
  • Date Posted: 7th May, 2019
  • Reference: ObjC57


Technology & Skill: C, C++, Pro C, Linux

Domain: US Healthcare (Specifically Claims Processing Cycle)





REQUIREMENTS AND RESPONSIBILITIES:

· Should be very strong in C, C++, Pro C, and Linux with fair knowledge of the language specification.

· Should have hands on experience on oracle database.

· Should have strong knowledge about message protocols, SVN tools and TFS etc.

· Should have thorough knowledge of the standard library, STL containers, and algorithms.

· Should be very strong in OOPS concepts and its implementation in real business scenarios.

· Should have strong knowledge on software development lifecycle and its different phases.

· Should be able to resolve defects/'service requests' logged by client and proactively deliver high quality solutions.

· Should coordinate with other stake holders for understanding issues and providing real time solutions.

· Should have experience in 'ticket management application' knowledge like Jira, salesforce, Remedy etc.

· Claims functional workflow and claims adjudication engine workflow knowledge will be an added advantage.

· Claims processing to ensure quality (in/out patient hospital claims, Medicaid, medical, and Medicare claims)

· Review auto adjudication of claims Review carve-outs in the Division of Financial Responsibility (DOFR)

· Recommend and assist in the development of process improvements Claims Adjudication Processing Coordinating with various departments to resolve disputes or issues

· Able to process a claim and assist the team by answering questions and providing support Prepare for check runs other duties may be assigned as needed to assist the team.