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Quality Assurance Analyst

Company: Zelis Payments
Location: Clearwater
Posted on: June 8, 2021

Job Description:

Position OverviewAudit of applications, directory files, system logic, production data and processes to ensure systems are working according to specifications and output meets KPI expectations.Generates reports on provider demographic and fee schedule records and audits output for validity.Develops and analyzes reports to trend data.Researches and resolves discrepancies that may arise through problem solving and interaction with other departments.SummaryofResponsibilitiesConduct user acceptance testing of projects related to system and program logic modifications for accuracy and effectiveness.Document and communicate successes and defects.Audit network re-pricing rules to verify the network is loaded and repricing accurately.Track and communicate findings.Develop and execute audits of completed data entry and data processed through conversions to ensure that all meet quality standards set forth in the KPI. Track and report on associate accuracy rates.Develop and execute audits of website directory for accuracy and duplication.Track and report on findings.Reviews and validates network data for accuracy.Develop and track quality audit metrics.Review trends for process improvement.Investigates data related issues to identify root cause of issues, identify solution and communicate outcome.Validates dental provider service locations and updates findings in user interface.Develop reports to trend data to identify fluctuations and variances.Participate in projects related to provider data, system logic and application updates.Provide feedback to ensure project is being executed as requested.CompetenciesKnowledge of MS Office and related applications.Demonstrates the ability to learn and utilize Zelis proprietary systems.Expert knowledge of MS Access and Excel.Proficient knowledge of relational databases.Knowledge of network repricing logic and provider matching.Ability to utilize multiple resources to validate data: data mining, phone calls, etc.SummaryofQualificationsBachelors Degree with two (2) or three (3) years related experience and/or training or equivalent combination of education and experienceDetailed oriented with strong written and oral communication.Ability to learn and utilize Zelis proprietary systemsProficient with MS Office (Word, Excel and Access), Outlook and Internet, FTP sites and downloading of files.work environment Possesses detail-orientation as well as strong written and oral communication skills. Demonstrates self-motivation and the ability to work independently and as a team. Demonstrates ability to handle, balance and prioritize workload from various service units and individuals in a fast-paced environment. Ability to deal with problems involving a few concrete variables in standardized situations. Zelis is a healthcare and financial technology growth company and market-leading provider of claims cost management and payments optimization solutions to price, pay and explain healthcare claims. Zelis delivers integrated network analytics, network solutions, payment integrity, electronic payments and claims communications for payers, healthcare providers and consumers in the medical, dental and workers' compensation markets nationwide. Zelis is backed by Parthenon Capital Partners and Bain Capital.

Keywords: Zelis Payments, Clearwater , Quality Assurance Analyst, Other , Clearwater, Florida

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