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Business Analyst

Company: Wipro Limited
Location: Canfield
Posted on: June 24, 2022

Job Description:

Overview:Provider Contract Analyst
We are seeking a Contract Analyst in our Westerville, OH office. This person will be responsible for providing companywide assistance with analysis and interpretation of client provider contract and pricing information. The candidate must have experience or exposure to working with healthcare providers or health insurance companies.

The primary responsibility of this position will be reviewing the provider contracts, interpreting the medical/insurance codes and contractual arrangements to enter pricing into the claim system.

  • Minimum 3 year related experience in healthcare and/or insurance industry with contracts
  • Strong knowledge of CPT, ICD-10, and HCPCS coding.
  • Strong knowledge of interpreting provider contracts and pricing arrangements.
  • Working knowledge of contract configuration required.
    Roles & Responsibilities:ESSENTIAL JOB FUNCTIONS/DUTIES

    • Analyze and interpret provider contracts, pricing requirements and update systems to accurately apply contract details. Will interpret the code (payment arrangement) and enter into claim system.
      • Provide support to staff regarding provider contract analysis and system configuration.
        • Update customer specific documentation and reference materials.
          • Assist with testing of information systems to ensure proper configuration of contracts and pricing.
            • Participate in client facing meetings and related direct communication efforts as needed.
              • Recommend changes in policies, procedures, or services to management based on benefit/contract changes.

Keywords: Wipro Limited, Canton , Business Analyst, Professions , Canfield, Ohio

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