Scope and Purpose of Position: The Claim Testing Analyst will support testing within Operations. Engage with other departments to ensure testing is complete and accurate. Essential Functions: Assist in department/corporate projects, as assigned by Manager/Director, in an effort to ensure that system upgrades and/or changes in procedures and/or benefits are implemented accurately Provides claims support for new group implementation Assist department Manager with reviewing and reprocessing claims related to retroactive configuration changes Performs User Acceptance Testing as enhancements are made to system Assist in the coordination of provider check generation including report validation and troubleshooting/resolution of suspended/voided check files. Assist other departments with claims related issues related to check tracers and EOP/EOB generation. Coordinate work with other departments to ensure testing is completed timely and accurately Identify system issues, business requirements, and/or enhancements Provide support related to inventory analysis Assist in resolution of escalated claim inquiries Other duties as assigned Education and Experience: Minimum of 5 years relevant work experience and experience in managed health care is required Understanding and knowledge of claims processing and adjudication Knowledge of medical terminology, ICD-9, ICD-10 and CPT-4 coding and managed care claims administration Competencies: Good working knowledge of claims adjudication systems Excellent interpersonal skills Timely and thorough problem resolution skills Strong organizational skills and the ability to be resourceful in problem solving. Strong communication skills - written and verbal Demonstrated use of good judgment Ability to work independently utilizing company established processes Strong attention to detail and follow-up skills Ability to meet deadlines Team orientation and ability to work effectively across functional areas of the company Ability to work in fast pace and evolving environment Accuracy, attention to details and analytical skills Excellent analytical, problem resolution and people skills Ability to deliver quality results under tight deadlines Ability to work independently with moderate supervision Ability to multi-task and prioritize projects/assignments