Healthcare Claims Consultant for Financial Operations

1 week ago


Atlanta, Georgia, United States Volt Full time

Innova Solutions is a leading provider of strategic technology and business transformation solutions. We are seeking an experienced Healthcare Claims Analyst to join our team as a Contract Professional.

Job Overview

The ideal candidate will have a minimum of 12-15 years of experience in the IT industry, with prior experience in implementing/maintenance of commercial payer claims solution and/or Medicare/Medicaid system.

The role requires strong knowledge in claims processing concepts, provider, member enrolment and care management concepts, reference code/data sets required in Claims adjudication including CPT, CDT, HCPCS, ICDs, benefits or programs configuration across various sub-systems, and requirements documentation.

The successful candidate will be responsible for working closely with the client and development team during the stages of development, conducting demos at completion of milestone, tracking and closing feedback from such demos, and creating mapping documents for various interfaces and including business rules, transformation and DB mapping.

Key Responsibilities:



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