Implementation Specialist/QA Analyst

Healthcare Fraud Shield - Chesterfield, MO

Full-time - Entry Level

Remote - Chesterfield, MO

About the position

The Implementation Specialist/QA Analyst role focuses on managing implementation tasks related to healthcare fraud prevention, ensuring high standards in client onboarding processes. The position requires strong project management, analytical skills, and effective communication with clients and internal teams to facilitate data analysis and testing for new client implementations.

Responsibilities

• Manage assigned implementation tasks to the highest standards.
• Apply strong project management and organizational skills to implementation processes.
• Utilize analytical and problem-solving skills to identify obstacles in the client onboarding process.
• Perform client data file analysis related to medical and pharmacy claim data.
• Assist in documentation related to client data feeds, including mapping and special data manipulation.
• Assist in testing for new client implementations.
• Work effectively with internal teams to identify resources to overcome client data obstacles.
• Communicate with clients to discuss data needs, provide status updates, and guide the installation process.
• Provide regular status updates to both internal staff and client resources.
• Manage project schedules and timelines in project management software.
• Deliver a high level of customer service at all times.
• Understand and comply with all company Privacy and Security standards.
• Review and analyze system specifications and execute test cases.
• Create logs to document testing phases and defects and report bugs to development teams.
• Help troubleshoot issues and conduct post-release testing.

Requirements

• Bachelor's degree required, focus in Health Insurance or Administration preferred.
• 3+ years' experience working with Health Insurance claim data or in a related industry preferred.
• 1-2 years Claim Analyst or related experience, preferably in system configuration.
• Advanced knowledge of Microsoft Office Suite including Word, Excel, Project, and Outlook.
• Proven experience as a QA tester or similar role (SQL preferred, not required).
• Ability to document and troubleshoot errors.
• Excellent communication skills both verbally and written.
• Attention to detail and analytical mind with problem-solving aptitude.
• Customer service minded and detail-oriented.
• Excellent troubleshooting and problem-solving skills.

Nice-to-haves

• Experience in healthcare IT, clinical informatics, or Healthcare Fraud, Waste and Abuse (FWA).
• Knowledge of health care, insurance, medical terminology, CPT, HCPCS, DRG, Revenue, ICD-9, ICD-10 preferred.
• SQL experience preferred.
• Outstanding organizational and time management skills.

Benefits

• Medical, Dental & Vision insurance
• 401(k) retirement savings with employer match
• Vacation and sick paid time off
• 8 paid holidays
• Paid maternity/paternity leave
• Disability & Life insurance
• Flexible Spending Account (FSA)
• Employee Assistance Program (EAP)
• Professional and career development initiatives
• Remote work eligible