Domain Specialist - Health Insurance - Payer

Health Insurance Specialist

One of our client is looking for a Domain Specialist in Healthcare space. The brief Job requirement is given below :

Job Requirement :

- Significant experience in the Health Insurance (Payer) domain

- Prior experience working in a Payer organization will be strongly preferred

- Deep knowledge of processes like member enrolment, eligibility verification, claims adjudication, underwriting, payments, medical coding, billing, denial management etc.

- Knowledge of IT products/solutions used in the Health Insurance workflow is a must

- Awareness of trends in Health Insurance for the USA geography is desirable (e.g. Obama care legislations, HITECH/ARRA, HIPAA, Meaningful Use, changes in Medicare/ Medicaid etc.)

- Proven experience planning, designing, and implementing mid/ large scale business-IT solutions in the Payer environment

- Certifications in Insurance or in the IT field would be an advantage