Data Analysis

About Us 

Zelis is modernizing the healthcare financial experience in the United States (U.S.) across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.

Why We Do What We Do 

In the U.S., consumers, payers, and providers face significant challenges throughout the healthcare financial journey. Zelis helps streamline the process by offering solutions that improve transparency, efficiency, and communication among all parties involved. By addressing the obstacles that patients face in accessing care, navigating the intricacies of insurance claims, and the logistical challenges healthcare providers encounter with processing payments, Zelis aims to create a more seamless and effective healthcare financial system.

Zelis India plays a crucial role in this mission by supporting various initiatives that enhance the healthcare financial experience. The local team contributes to the development and implementation of innovative solutions, ensuring that technology and processes are optimized for efficiency and effectiveness. Beyond operational expertise, Zelis India cultivates a collaborative work culture, leadership development, and global exposure, creating a dynamic environment for professional growth. With hybrid work flexibility, comprehensive healthcare benefits, financial wellness programs, and cultural celebrations, we foster a holistic workplace experience. Additionally, the team plays a vital role in maintaining high standards of service delivery and contributes to Zelis’ award-winning culture. 

Position Overview

The UAT Analyst will be responsible for ensuring claim opportunities are maximized in the Out of Network Department through monitoring of inventory, routing of claims and ensuring quality measures are applied for best outcomes. The responsibilities are inclusive of monitoring claim volume and turnaround time, reviewing claim routing decisions made by associates, and identifying claim savings opportunities. All responsibilities encompassed include execution within both the Zelis Claim Management System and/or the Zelis Compass system. This role will also be part of the Out of Network ART Scrum Team and will be responsible for the end-to-end user acceptance testing of the new and enhanced features/services envisioned for planned releases.

• Perform end to end testing to ensure appropriate functionality, product integrity, accuracy, and quality of all changes and enhancements related to the OON product.
• Analyze operational and technical requirements and define the scope of UAT testing. Setup, develop and maintain detailed test scenarios, test suites, data, checklist and/or other documents as specified, ensuring scenarios are directly aligned to requirements. 
• Analyze and troubleshoot erroneous results, determine root cause, and suggest solutions.
• Ensure test scenario documentation is detailed, accurate and in a consistent format, demonstrating strong analytical and documentation skills.
• Continuous improvement and refinement on tests based on pre-production validation, post-production results and feedback from other groups (Configuration Department, Content Department and Operations teams) as needed.
• Support multiple projects, initiatives, tasks, and maintenance releases while adhering to deadlines.
• Identify and discuss with management, claims that may have routing or processing concerns in comparison to expectations in production environment.
• Maintain awareness of and ensure adherence to Zelis standards regarding privacy.
• Assist with the creation and/or updates of standard operating procedures by collaborating with and others including but not limited to OON Services
• Participate and assist in user-story development during Scrum grooming and planning sessions.
• Maintain postproduction reporting to ensure quality of deployment meets expectations. 
• Collaborates with the scrum team to define user stories and acceptance criteria for end-to-end user acceptance testing.
• Identify and assist in investigative items to potentially resolve production defects and furthermore create future enhancements.
• Participate in the Sprint Retrospective, where the teams gather to improve their existing processes while actively engaged in planning the next releases.
• Act as SME between Business and Scrum Team to communicate upcoming deployments, demo, production defects etc.
• Explaining operating procedures or policies to fellow team members
• Prioritize projects based on business need.
• Assess risks and develop strategies to lower probability of errors and/or quality of out of network products.
• Effectively communicate substantial analysis that identify meaningful trends and opportunities across the business.

Professional Experience:

• 3 years of healthcare insurance experience is preferred.
• Exceptional verbal, written and visual communication skills
• SQL Experience preferred but not mandatory

Education:

• High School Diploma or equivalent required
• Bachelor’s Degree/ preferred, not required