Job Description :
Transform business requirements into feasible design solutions using Pega 8.x, Pega 7.X
Implement functionality to Intake claims received through various input channels like Fax, Mail, Manual entry, etc.
Setup file listeners for different types of prior authorization requests.
Create Map structured rules; Data transforms to map inbound data into the data model.
Design Review and Decision process for prior authorization cases.
Design Outreach process for gathering details needed for case processing.
Design and implement an exception handling mechanism for file and service operations.
Implement complex file transformations for generating output file(Outtake files) as per customer needs.
Design and implement correspondence templates as per business needs.
Co-ordinate with various teams to design integrations and implement technical solutions using REST/SOAP.
Creating and executing Unit Test plans, defect identification and fixing, code deployments.
Design and develop reports per customer needs.
Delivers technical leadership and is able to mentor others in the organization.