Experience Summary ICD-10 VMS Test Expert writes, reviews and tests, test cases to implement the ICD-10 process * Reviews basic system enhancements/upgrades to determine applicability of customer (CMS) file modification requirements, and follows clearly defined procedures * Writes and tests test-cases with regards to Vips Medicare System (VMS) changes and updates at the advisement of Centers for Medicaid and Medicare Services (CMS) * Attends weekly conference calls with the shared system maintainer (General Dynamics Information Technology (GDIT)) with regards to testing statuses and issues identified during testing * Attends staff meetings as instructed by management * Assists in facilitating timely and accurate updates to reference files based on customer (Centers for Medicaid and Medicare (CMS)) requests * Documents system problems to the maintainer and assists in the resolution * Reviews and completes various daily reports to ensure that the VMS system performs as expected * Communicates with management and departmental personnel to document workflow procedures * Assists in preparing verbal and written communication about business changes with management or other staff members * Processes and adjudicates claims with regards to ICD-9 and ICD-10 HCPCS codes to include analysis of beneficiary claims history, diagnosis, supplier information, etc. * Coordinate daily with other lines of business (LOBs) in order to review and discuss Point of Contact (POC) analysis of change requests (CRs) when they are issued by CMS * Performs peer-reviews of testing completed by co-workers * Performs other duties as instructed by management and/or team-lead.

Highlights:

• Management
• Medicare
• Asset Liability Management
• Audit
• Business Analysis
• Business Analyst
• Certified Fraud Examiner
• Cms
• Complaints
• software