Identifying Business Requirements for a Billing and Reconciliation System Replacement

Our health plan client wanted to replace their antiquated billing and reconciliation systems that supported eligibility, fiduciary and reconciliation processes for their largest customer. Their goal with the new system platform was to improve internal reconciliation turnaround times, provide better reporting to their customers, and provide future flexibility for new product types. They needed documented, detailed business requirements to ensure development of the new system was achieved in a manner that met the unique business scenarios.

Diamond i’s role was to serve both as business project manager and business analyst to gather, define and document the business and reporting requirements for the client’s new system. Diamond i managed the project, reporting in to various committees and project sponsors; conducted internal and external interviews to define requirements; performed a high level gap analysis of the current billing system to requirements; and then transitioned all work to the client’s project staff.

As a result of Diamond i’s work, project management and status reporting was maintained during the absence of the client’s project manager. Detailed business requirements were documented and so that functional design and system development could begin.

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