Edifecs Claims and Encounters SME
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Job Location:
Atlanta, GA - USA
Monthly Salary:
Not Disclosed
Posted on:
8 hours ago
Vacancies:
1 Vacancy
Job Summary
Key Responsibilities
Problem Definition & Functional Consulting
- Engage with business IT and compliance stakeholders to understand requirements regulatory mandates and operational challenges related to Claims and Encounters
- Analyze currentstate systems workflows and data to identify gaps risks and improvement areas
- Convert complex business and regulatory needs into welldefined solution requirements.
- Lead solution design and configuration approach for Edifecs Claims and Encounters implementations
- Evaluate multiple design and process options assess impact and feasibility and recommend bestfit solutions
- Ensure solutions conform to state Medicaid CMS and encounter compliance standards
- Provide handson leadership for Edifecs components including:
- Claims and Encounter intake validation and reconciliation
- Edifecs configuration and rule frameworks
- Downstream integrations and reporting
- Work closely with development testing and integration teams to ensure quality performance and compliance
- Review designs configurations and outputs to prevent downstream compliance defects
- Manage medium to large initiatives with multiple dependencies and overlapping timelines
- Track milestones risks and issues; take corrective action where required
- Participate in effort estimation planning and delivery execution ensuring predictability and stability
- Act as a key point of contact for Edifecsrelated delivery with stakeholders
- Communicate progress risks and solution decisions clearly and effectively
- Support issue resolution by balancing client priorities compliance needs and delivery constraints
- Guide and mentor junior consultants and SMEs on Edifecs and encounter processing
- Contribute to project documentation best practices and reusable assets
- Support onboarding and enablement of new team members as the program scales
- Candidate must be located within driving distance or willing to relocate toAtlanta GA.This position may require travel to project/client location/s in USA.
- Bachelors degree or foreign equivalent required from an accredited institution. Will also consider three years of progressive experience in the specialty in lieu of every year of education.
- At least 7years of Information Technology experience.
- Strong specialization in Edifecs Claims and Encounters
- Handson experience delivering healthcare/Medicaid encounter solutions
- Solid understanding of statespecific encounter and compliance requirements
- Proven ability to independently drive complex solution delivery
- Strong collaboration communication and problemsolving skills.
- Candidates authorized to work for any employer in the United States without employer-based visa sponsorship are welcome to apply. Infosys is unable to provide immigration sponsorship for this role at this time
- Prior experience with healthcare or similar Medicaid payer customers
- Experience supporting multistate implementations
- Onshore clientfacing delivery experience in regulated environments
The job entails sitting as well as working at a computer for extended periods of time. Should be able to communicate by telephone email or face to face. Extensive travel may be required as per client and project needs.
Benefits
Along with competitive pay as a full-time Infosys employee you are also eligible for the following benefits:
- Medical/Dental/Vision/Life Insurance
- Long-term/Short-term Disability
- Health and Dependent Care Reimbursement Accounts
- Insurance (Accident Critical Illness Hospital Indemnity Legal)
- 401(k) plan and contributions dependent on salary level
- Paid holidays plus Paid Time Off
About Us
Infosys is a global leader in next-generation digital services and consulting. We enable clients in more than 50 countries to navigate their digital transformation. With over four decades of experience in managing the systems and workings of global enterprises we expertly steer our clients through their digital journey. We do it by enabling the enterprise with an AI-powered core that helps prioritize the execution of change. We also empower the business with agile digital at scale to deliver unprecedented levels of performance and customer delight. Our always-on learning agenda drives their continuous improvement through building and transferring digital skills expertise and ideas from our innovation ecosystem.
EEO
Infosys provides equal employment opportunities to applicants and employees without regard to race; color; sex; gender identity; sexual orientation; religious practices and observances; national origin; pregnancy childbirth or related medical conditions; status as a protected veteran or spouse/family member of a protected veteran; or disability.
About Company
Welcome to Infosys Careers for Experienced Professionals As a leading provider of next-generation consulting, technology and outsourcing solutions, we are dedicated to helping organizations in over 46 countries to renew their core and simultaneously innovate into new frontiers. Whilst ... View more
