What are the responsibilities and job description for the Healthcare Insurance BA (SME) position at Damco Solutions?
10-12 years of Health SME (Subject Matter Expert) experience, Preferably in health care or health insurance industry
Health, Hospital / Wellness, Cancer, Critical Illness, MEC1-Skinny Limited Medical, MEC2-Limited Medical, MEC3-Limited Medical products expertise is a must in US region.
Proven experience with underwriting processes, policy admin systems, claims process, benefit configuration, Form generation, and integrations with down and upstream systems.
Proven experience in implementing Health portals following ANSI EDI standards.
Experience with Health insurance systems for carriers and MGAs
Exposure to Medicaid and Medicare systems
Knowledge and Experience in billing, Claims, HIPAA regulations, EDI files
Proficiency in requirements gathering, process modelling and documentation
bility to collaborate with stakeholders at all levels internally and clients
Familiarity with industry specific tools for policy administration, claims management and underwriting
Experience in integration of core system with portals and apps.
Extensive experience in functional integration with associated third-party systems
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Phoenix, AZ
Full Time