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Senior IT Systems Analyst

Company: Insight Global
Location: Richmond
Posted on: November 26, 2022

Job Description:

-Implement, support, enhance, and configure the QNXT health claims system by prototyping, analyzing, implementing, and documenting the process changes.- Serve as resident QNXT Application Expert Creating custom SQL queries in SQL server databases.- Analyze application configuration to ensure it is efficient in setup and functionality.- Provide feedback into business requirement documents used to build custom solutions and interfaces.- Provide project management and oversight on ongoing QNXT related projects based on Manager's direction.- Evaluate solutions and configuration activities to ensure that the most efficient solutions are implemented.- Assist in the writing of department policy and procedure documents.- Develop and recommend operational processes improvements and ensure that technical configuration meets the organization's business needs.- Develop process maps as needed.- Develop 'helpful hints' or other job aides to assist team members.- Train new employees as needed.- Attend meetings for Manager at Manager's request or in their absence.- Provide data validation for conversion and interface data.- Partner with our testing team/business areas to develop and execute appropriate test plans and ensure the configuration or customization changes work as was intended.- Document functional specifications for system solutions and enhancements to existing business systems. Minimum Requirements- 3+ years of experience working in Information Systems or other related areas providing application support and/or configuration management.- 3+ years of working experience in health insurance industry.- 3+ years of experience writing TSQL or SQL queries.- Demonstrated experience around Trizetto/ Cognizant QNXT Systems Configuration, version 5.3 or later.- In-depth knowledge around Claims, Benefits, Service Group Design, Contracts, QNXT Rules, QNXT Edit -Structure and Fee Tables required.- Experience with developing SQL queries and working with QNXT back-end tables.- Strong analytical and critical thinking skills.- Ability to work independently in a hands-on role.- Strong facilitation skills.- In-depth understanding of System Design Methodologies.- Demonstrated ability to manage multiple timelines and priorities.- Proficient knowledge of flow charting/process mapping.- Understanding of the Insurance Marketplace, especially government programs (Medicare and Medicaid).- Functional knowledge of healthcare claims processes and payment methodologies such as (MS-DRG, APR- DRG, APC, OPEAPG, ASC Groupings, Per Diem and Capitation).- Functional understanding of health care claim data sets such as ICD-10, CPT, HCPCS, and Rev Codes.- Understanding of member benefit configuration such as Deductibles, Co-Pays, Co-Insurance, Benefit Maximums and Accumulators.- Bachelor's Degree in any field Desired Skills- Bachelor's Degree with focus in Computer Science, Information Systems, Business, or related technical field- Project Management experience

Keywords: Insight Global, Richmond , Senior IT Systems Analyst, Professions , Richmond, Virginia

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