Benefit Configuration Analyst - Health Insurance

The Benefit Configuration Analyst is key in ensuring the accuracy of critical information within our databases while adhering to respected timelines. This position includes collaborating with cross-functional teams to define requirements and serving as the initial configuration analyst, creating and managing requirements within the platform.

Position is based in either the Tampa or Atlanta metro region and candidates will currently need to live within those locations. Local Candidates Only Please. Key responsibilities include:

Update and maintain benefit plans, provider contracts, fee timelines, etc. Develop configuration standards and best practice guidelines to maintain accuracy, efficiency and automation plus overseeing the integration with external and internal systems and/ or programs. Perform system error root cause analysis and resolve benefit and pricing-related claims payment issues Analyze and translate business specifications into detailed technical specifications based on system functionality and develop non-systematic workaround processes when necessary. Interpret specific state and/or federal benefits, contracts plus the business requirements then converting these terms to configuration parameters Test, track and approve new system functionality and enhancements, Debug issues, providing timely fixes that include the development and execution of test plans and scripts Required Qualifications Bachelor's degree and above Currently live in the Tampa, Fl or Atlanta GA area 2 - 3 Years of experience in US Healthcare and in Benefit Configuration

• Benefit coding / Auto Adjudication Set up processes and Quality testing. Experience with medical plan benefit configuration using the Facets system /SQL and database experience with basic queries.
  
  Excellent US Healthcare knowledge in Benefits coding and validation Excellent communication skills and experience in working with US clients directly. Ability to complete the assigned tasks on time, Understand the SLAs and ensure they are met. Ability to coordinate with the Leads and Onshore in work prioritization and able to track and report self-work.
  
  Ability to work independently with onshore/offshore team to deliver the assigned projects. Good Analytical and problem-solving skills 1 - 2 Years of experience in US Healthcare and in Benefit Configuration

• Benefit coding / Auto Adjudication Set up processes. Good Analytical and problem-solving skills 3-4-year overall experience in US healthcare plans handling BIM and facets configuration process.
  
  Conduct training sessions for new hires and existing team members covering benefit coding principles, Facets configuration guidelines. Provide hands-on training sessions on the utilization of the Facets system for benefit configuration. Conduct training needs assessments to identify gaps in knowledge and skills to ensure training throughput.
  
  Familiarity with healthcare policies, regulations, and compliance requirements, such as HIPAA and ACA. Proficiency in different types of health insurance plans, including HMOs, PPOs, and government-sponsored programs like Medicare and Medicaid. Proficient in MS office including outlook, word, excel and power point. Claims_Processing