Billing Rules Associate

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Billing Rules Associate

Role Summary
Billing Rules Associate is a hybrid role based in Chennai, India that supports the testing and validation of billing rules across practice-specific, federal health, and payer-specific workflows. This position helps confirm that billing rules are tested against approved requirements and that results are documented accurately for sign-off. The role works closely with cross-functional partners to review requirements, validate outcomes, and support readiness for production. This position will report to the Manager.

Team Summary
This team is responsible for testing billing rules in a pre-production environment using internal tools and verifying that the rule designer output aligns with business requirements and expected testing outcomes. The work involves coordinating with internal stakeholders across India and the U.S. to clarify requirements, review test results, and support sign-off on rule changes. The team supports a broad range of rule types, including practice-specific rules, federal health rules, payer-specific rules, and Federally Qualified Health Center (FQHC) workflows. Success in this role depends on clear communication, careful validation, and consistent follow-through across teams.

Essential Job Responsibilities

• Review billing rule requirements and confirm they are reflected accurately in test scenarios and expected outcomes.
• Execute billing rules testing in a pre-production environment using internal tools and document results against approved business requirements.
• Validate rule designer configurations to ensure alignment with billing rules, practice-specific rules, federal health rules, payer-specific rules, and FQHC workflows.
• Coordinate with stakeholders across India and the U.S. to clarify requirements, review test results, and support issue resolution.
• Identify gaps between business requirements and testing outcomes and communicate findings clearly for resolution.
• Track defects, retest fixes, and confirm that updates meet expected billing rule behavior.
• Prepare test evidence, status updates, and sign-off documentation for assigned billing rule work.
• Support billing process validation by applying knowledge of billing rules and healthcare workflows.
• Apply AI-enabled tools or features, when available, to help organize test evidence, summarize findings, or improve task efficiency while using human review to confirm accuracy and final decisions.

Additional Job Responsibilities

• Assist in reviewing process updates and contributing to improvements in testing methods.
• Participate in team discussions to share observations and support knowledge transfer.
• Help maintain documentation related to billing rules testing and validation.
• Escalate issues that may affect timelines, quality, or accuracy of testing deliverables.
• Contribute to audit readiness by keeping test records complete and organized.
• Support ad hoc analysis related to billing rule behaviour or testing questions.
• Collaborate on standardization efforts that improve consistency in rule validation.
• Perform other related duties as assigned.

Expected Education & Experience

• Bachelor’s degree in a related field or equivalent practical experience.
• 0 to 5 years of experience in healthcare operations, billing, testing, or a related business systems role.
• Experience or familiarity with billing rules review, validation, or testing.
• Experience or familiarity with practice-specific rules, federal health rules, payer-specific rules, and Federally Qualified Health Centre (FQHC) billing workflows.
• Ability to review requirements, compare expected versus actual outcomes, and document results clearly.
• Strong written and verbal communication skills for working with internal stakeholders across multiple locations.
• Ability to manage multiple assignments, follow testing steps, and meet deadlines in a hybrid work environment.
• Experience using testing, workflow, or documentation tools is preferred.