Hi ram,
Hope you are doing well.
(Only share local profiles Philadelphia, PA / Hybrid & 8 + years must – NO GC (IF GC need PP number)
1. Role: Sr. QA Manual Tester (HIPAA & Healthcare claims and 8+ years must)
Location: Philadelphia, PA / Hybrid (Locals Only)
Duration: 12+ months
Contract: C2C
Locals only – PA – 8+ years exp must.
Job Description:
· Member Enrolment, Claims Adjudication, Provider, Prior Authorization, Billing and Payment.
· Expert in developing, processing, and verifying healthcare claims using HIPAA EDI 837 I/P/D transaction sets
· Good at validating HIPAA 835 Remittance Advise and 276/277 for Claim status enquiry and response transactions
· Excellent knowledge on HIPAA standards, 999 Accept/Rejection Acknowledgement SNPI level validations
· Experienced in validating cross-over (Medicaid vs Medicare), TPL (Third Party liability) claims
· Coinsurance, deductible, out of the pocket maximums for various benefit configurations and Plans.
