NASCO Claims Domain Specialist
Full Time
Part Time
On-site
Fitment
Dice Job Match Score™
⭐ Evaluating experience...
Job Details
Skills
- HTML
- HTTP
- Health Insurance
- Pharmacy
- Acceptance Testing
- Pricing
- Test Plans
- Test Scenarios
- Workflow
- Electronic Data Interchange
- Health Care
- Regulatory Compliance
- HIPAA
- Medicare
- Medicaid
- Quality Assurance
- Root Cause Analysis
- Leadership
- Stakeholder Management
- Mentorship
- Offshoring
- Testing
Summary
- 15+ years of experience in US Healthcare Insurance with strong NASCO Claims domain expertise.
- Serve as the primary SME for end-to-end NASCO Claims Processing (Professional, Institutional, and Pharmacy claims).
- Lead UAT planning, execution, validation, and business sign-off activities.
- Strong knowledge of Claims Adjudication, Pricing/Repricing, Accumulators, COB, and Subrogation.
- Review and validate test plans, test scenarios, test data, and claims workflows.
- Expertise in EDI transactions including 837, 835, 270/271, and healthcare claims lifecycle.
- Ensure compliance with CMS, HIPAA, Medicare, Medicaid, and Commercial Health Plan requirements.
- Act as the key liaison between Business, Product Owners, Operations, Development, and QA teams.
- Lead defect triage, root cause analysis, and testing governance activities.
- Strong leadership, stakeholder management, and mentoring experience with onsite/offshore testing teams.
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
- Dice Id: 91018020
- Position Id: PDT - 11775-12910-1785362773
- Posted 3 hours ago
Company Info
About Purple Drive Technologies LLC
Founded in 2007, Purple Drive started as a tech solutions firm and has grown into a full-service consulting and talent partner. We help businesses navigate complex technology challenges while connecting top professionals with career-defining opportunities.
We believe in transforming businesses through smart IT solutions and empowering technologists to grow their expertise through challenging projects and meaningful partnerships. Built on over 20 years of trusted relationships, we create success stories for both our clients and the talented professionals who drive innovation forward.
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