Senior UAT Analyst
The Senior UAT Analyst will be responsible for ensuring claim opportunities are maximized in the Out of Network Department through monitoring of inventory, routing of claims and ensuring quality measures are applied for best outcomes. The responsibilities are inclusive of monitoring claim volume and turnaround time, reviewing claim routing decisions made by associates, and identifying claim savings opportunities. All responsibilities encompassed include execution within both the Zelis Claim Management System and/or the Zelis Compass system. This role will also be part of the Out of Network ART Scrum Team and will be responsible for the end-to-end user acceptance testing of the new and enhanced features/services envisioned for planned releases.
Perform end to end testing to ensure appropriate functionality, product integrity, accuracy, and quality of all changes and enhancements related to the OON product.
Analyze operational and technical requirements and define the scope of UAT testing. Setup, develop and maintain detailed test scenarios, test suites, data, checklist and/or other documents as specified, ensuring scenarios are directly aligned to requirements.
Analyze and troubleshoot erroneous results, determine root cause, and suggest solutions.
Ensure test scenario documentation is detailed, accurate and in a consistent format, demonstrating strong analytical and documentation skills.
Continuous improvement and refinement on tests based on pre-production validation, post-production results and feedback from other groups (Configuration Department, Content Department and Operations teams) as needed.
Support multiple projects, initiatives, tasks, and maintenance releases while adhering to deadlines.
Identify and discuss with management, claims that may have routing or processing concerns in comparison to expectations in production environment
Responsible for analyzing and maintaining assigned hi-touch queues associated with OON services.
Maintain awareness of and ensure adherence to Zelis standards regarding privacy.
Assist with the creation and/or updates of standard operating procedures by collaborating with and others including but not limited to OON Services
Participate and assist in user-story development during Scrum grooming and planning sessions.
Maintain postproduction reporting to ensure quality of deployment meets expectations.
Collaborates with the scrum team to define user stories and acceptance criteria for end-to-end user acceptance testing.
Identify and assist in investigative items to potentially resolve production defects and furthermore create future enhancements.
Participate in the Sprint Retrospective, where the teams gather to improve their existing processes while actively engaged in planning the next releases.
Act as SME between Business and Scrum Team to communicate upcoming deployments, demo, production defects etc.
Explaining operating procedures or policies to fellow team members
Prioritize projects based on business need
Assess risks and develop strategies to lower probability of errors and/or quality of out of network products
Effectively communicate substantial analysis that identify meaningful trends and opportunities across the business
3 years of healthcare insurance experience is preferred.
Exceptional verbal, written and visual communication skills
Bachelor’s Degree/ preferred, not required
SQL Experience preferred but not mandatory
Travel requirements to (primarily) domestic destinations should not exceed 10%.
A standard work week exists but with the understanding that additional time/effort outside of the usual parameters can/will occur based upon the overall needs of the integration, where deadlines exist and when necessary due to the needs of the integration team.
A standard business environment exists with moderate noise levels.
Ability to sit for extended periods of time.
As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.
Commitment to Diversity, Equity, Inclusion, and Belonging
At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.
Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.
We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com
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