Responsibilities
- Develop, configure, customize, and support HealthEdge HealthRules and HealthRules Payor solutions.
- Implement healthcare insurance processes covering claims, benefits, enrollment, membership, providers, pricing, and adjudication.
- Analyze business and technical requirements and translate them into HealthRules configurations and technical solutions.
- Develop and maintain integrations between HealthEdge platforms and external systems.
- Perform unit and integration testing, defect analysis, troubleshooting, root-cause analysis, and production support.
- Collaborate with business analysts, architects, developers, QA teams, and business stakeholders.
- Participate in design discussions, code and configuration reviews, deployment activities, and requirements analysis.
- Prepare technical, configuration, and support documentation.
- Ensure solutions meet healthcare standards, security requirements, and project guidelines.
Requirements
- At least 5 years of overall IT experience.
- Hands-on experience with HealthEdge HealthRules or HealthRules Payor.
- Strong understanding of US healthcare insurance and payer operations.
- Knowledge of claims, benefits, enrollment or membership, provider, and pricing processes.
- Experience with HealthEdge configuration, customization, healthcare application integrations, and APIs.
- Strong SQL skills for data analysis and troubleshooting.
- Understanding of SDLC, Agile methodologies, testing, and production support.
- Bachelor's degree in Computer Science, Information Technology, Engineering, or a related discipline, with 15 years of full-time education.
- Experience with HealthRules Connector or HealthRules Integration is preferred.
- Knowledge of EDI transactions including 834, 837, 835, and 270/271 is preferred.
- Experience with REST/SOAP APIs and integration technologies is preferred.
- Knowledge of HIPAA and X12 healthcare standards is preferred.
- Experience with US healthcare payer clients is preferred.
- Experience with Azure or AWS and DevOps/CI-CD processes is advantageous.
- Strong analytical, problem-solving, communication, and independent-working skills.
Benefits
- Hybrid work model in Hyderabad or Bangalore.
- Opportunity to work on large-scale US healthcare insurance projects with distributed teams.
- Production support responsibilities may be required when needed.
About Accenture
Accenture helps the world’s leading enterprises reinvent by building their digital core and unleashing the power of AI to create value at speed for organizations across industries. Our strategy is to be the reinvention partner of choice for our clients and lead in the safe, widespread adoption of AI, and to be the most client-focused, AI-enabled, great place to work in the world. We bring together the talent of our approximately 786,000 people with proprietary assets and platforms, deep process and industry expertise, and leading ecosystem relationships to deliver end-to-end solutions and measurable outcomes at scale. Through our Reinvention Services, we offer broad expertise across Cybersecurity, Digital Core, Finance, Industry and Enterprise, Song, Supply Chain and Engineering, and Talent, with advanced capabilities in AI and Data, Industry and Process, and Technology. We serve approximately 9,000 clients and generated approximately $70 billion in FY25 revenue. Visit us at accenture.com. This LinkedIn company page is moderated. When engaging with Accenture, we encourage everyone to: - Use common courtesy and be respectful of others. - Create your own original content and avoid content that you know to be fraudulent. - Never repost someone else's copyrighted work, unless you have permission. - Never post personal, identifying, or confidential information. We reserve the right to delete comments or posts we deem to be: - Profane, obscene, inappropriate, offensive, abusive material. - Spam, repeated comments and commercial messages and personal advertisements. - Discriminatory or that contain hateful speech of any kind regarding age, gender, race, religion, nationality, sexual orientation, gender identity or disability. - Threats; personal attacks; abusive, defamatory, derogatory, or inflammatory language; or stalking or harassment of any individual, entity or organization. - False, inaccurate, libelous, or otherwise misleading in any way.