TOPS CAST Functional Architect- * Collaborate with Business Partners and Developers from multiple applications to further refine business requirements documentation and determine the best possible solution that will meet the business needs. * Expert in EDI Transactions including: HIPAA 837 Professional/Institutional (both batch and real-time adjudication), HIPAA 835 Remittance Advice, HIPAA 278 Authorization/Notification/Referrals, HIPAA 270/271 Eligibility Inquiry, Claredi, HIPAA… Show more TOPS CAST Functional Architect- * Collaborate with Business Partners and Developers from multiple applications to further refine business requirements documentation and determine the best possible solution that will meet the business needs. * Expert in EDI Transactions including: HIPAA 837 Professional/Institutional (both batch and real-time adjudication), HIPAA 835 Remittance Advice, HIPAA 278 Authorization/Notification/Referrals, HIPAA 270/271 Eligibility Inquiry, Claredi, HIPAA 276/277 Claims Status and NSF/UB92 formats and how these formats interact with a claims adjudication system. * Proficient in Data SQL Query Language (SQL / DQL) into a relational database to utilize data obtained for deep dive analysis, reporting, determining value and confirm a successful release. * Responsible for early engagement for requests to any system change and support the estimation team for work sizing.* Proficient in creating process flows that span across multiple applications as well as claims adjudication complex logic changes to identify process improvement changes or system gaps. * Developed business area context diagrams, system area context diagrams, functional specs to analyze / confirm the definition of project requirements. * Actively working knowledge within the agile team setting to assist in backlog creation and grooming. Show less

* Authored business requirements, translated business requirements into capabilities/features to author and produce system design specifications.* Managed all cross-functional project written communication, weekly meetings and corporate presentations to update project participants, key stakeholders (both business and technical) and executive management on strategy, objectives and progress to ensure organizational requirements are addressed.* Ensure that project requirements adhere… Show more * Authored business requirements, translated business requirements into capabilities/features to author and produce system design specifications.* Managed all cross-functional project written communication, weekly meetings and corporate presentations to update project participants, key stakeholders (both business and technical) and executive management on strategy, objectives and progress to ensure organizational requirements are addressed.* Ensure that project requirements adhere to all applicable regulations, for example: HIPAA, SOX, ARRA, DOI and audit regulations. * Conduct current state analysis to gather current business, functional and non-functional requirements and constraints. * Lead solution architect for projects that spanned across multiple applications (25+), for example ICD10 and HIPAA version 5010. * Proficient in running JAD sessions, documenting and engaging necessary partners as impact is determined. * Ensure that project requirements are clearly and comprehensively documented, understood and support traceability matrix.* Conduct solution JAD sessions and formal reviews of required documents with business partners and other stakeholders to agree on proposed solution design and obtain approval. * Participate in test artifact reviews to ensure adequate coverage of the business and technical requirements are included in test documentation. Establish appropriate testing metrics, conduct testing activities to execute user acceptance testing to validate business requirements are met. Ensure that requirement documentation/estimation is clear, well defined and understood by the entire team. Show less