• Support CAS platforms including LogicGate, Onit and NetDocuments • Help migrate manual, Excel-based and legacy regulatory/risk reporting processes into more structured platform workflows • Elicit and document requirements, user stories, acceptance criteria, process flows and supporting materials • Support system enhancements, configuration, testing cycles, UAT, issue resolution and change documentation • Bring project discipline to small projects and enhancements through planning, milestones, toll gates and delivery follow-up • Partner with product, legal, risk, compliance, engineering and business stakeholders to translate needs into practical solutions • Contribute to process improvements that improve efficiency, controls, data integrity and automation across the back-office portfolio

• Perform various analysis and interpretation to link business needs and objectives for assigned function • Detailed reviews of both state specific and corporate Payment policies for Compliance and Governance • Review, analyze, and interpret coding, reimbursement, and regulatory guidelines • Develop, implement, and maintain Payment Policies, reimbursement methodologies, and claims editing logic • Monitor, report on, and track regulatory, coding, and policy updates • Support business initiatives through data analysis and user acceptance testing of new systems • Identify and analyze user requirements, procedures, and problems to improve existing processes • Perform detailed analysis on assigned projects and recommend business solutions

• Perform various analysis and interpretation to link business needs and objectives for assigned function • Responsible for payment integrity repository updates and ensuring it remains up to date and accurate • Review, analyze, and interpret coding, reimbursement, and regulatory guidelines to ensure organizational compliance and payment integrity • Develop, implement, and maintain Payment Policies, reimbursement methodologies, and claims editing logic to support accurate claims adjudication • Monitor, report on, and track regulatory, coding, and policy updates, ensuring timely implementation and communication of changes across impacted stakeholders • Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of new systems • Identify and analyze user requirements, procedures, and problems to improve existing processes • Perform detailed analysis on assigned projects, recommend potential business solutions and assist with implementation • Identify ways to enhance performance management and operational reports related to new business implementation processes • Develop and incorporate organizational best practices into business applications • Lead problem solving and coordination efforts between various business units • Assist with formulating and updating departmental policies and procedures • Performs other duties as assigned • Complies with all policies and standards

• Perform various analysis and interpretation to link business needs and objectives for assigned function • Ensuring our internal claims coding editors remain accurate, up to date, and compliant • Review, analyze, and interpret coding, reimbursement, and regulatory guidelines to ensure organizational compliance and payment integrity • Develop, implement, and maintain Payment Policies, reimbursement methodologies, and claims editing logic to support accurate claims adjudication • Monitor, report on, and track regulatory, coding, and policy updates, ensuring timely implementation and communication of changes across impacted stakeholders • Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of new systems • Identify and analyze user requirements, procedures, and problems to improve existing processes • Perform detailed analysis on assigned projects, recommend potential business solutions and assist with implementation • Identify ways to enhance performance management and operational reports related to new business implementation processes • Develop and incorporate organizational best practices into business applications • Lead problem solving and coordination efforts between various business units • Assist with formulating and updating departmental policies and procedures • Performs other duties as assigned