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Sr. Configuration Analyst (Remote)

Expired Job

Brooksource Dayton , OH 45402

Posted 3 months ago

Title: Configuration Analyst II

Term of Assignment: Approx. 4 months Contract-to-hire

Nature of Work: Configuration of provider agreements in Facets

Top skillsets: NetworX experience

Location: Dayton, OH

REQUIREMENT

High School Diploma or GED is required

Bachelor's Degree or equivalent years of relevant work experience is preferred

Minimum of three (3) years health plan experience, to include two (2) years of configuration or clinical editing software experience is required

Exposure to Facets is preferred

Advanced computer skills with Microsoft Word, Excel, Access, Visio and abilities in Facets

Proven understanding of database relationships required

Understanding of DRG and APC reimbursement methods

Understanding of CPT, HCPCs and ICD-CM Codes

Knowledge of HIPAA Transaction Codes

Critical listening and thinking skills

Decision making/problem solving skills

Enhanced communication skills both written and verbal

Can work independently and within a team environment

Attention to detail

Understanding of the healthcare field

Knowledge of Medicaid/Medicaprocessing skills

Proper grammar usage

Time management skills

Proper phone etiquette

Customer service oriented

Facets knowledge/training

Proper claim coding knowledge

Ability to be telecommuter

Broad understanding of business considerations and functionality preferred

Certified Medical Coder (CPC) is preferred

Role and Responsibilities

Manage and define system configuration requirements. Responsibility for requirements, definition, document, design, testing, training and implementation support using appropriate templates or analysis tool

Develop and utilize reports to analyze and stratify data in order to address gaps and provide answers to issues identified within the department or by other departments

Identify, manage and document the status of open issues, configuration design, and final resolution within change management system

Review and interpret regulatory items, timely delivery of required updates

Development of standard code set and reimbursement design templates

Plan and implement new software releases including testing and training

Participate in meetings with business owners, users and IT to achieve solutions that meet the requirements and expectation of CareSource Lead configuration initiatives in payment policy meetings and present to committees

Coordinate annual benefit changes with internal resources

Provide analysis of efficiencies related to system enhancement and automation. Review, analyze, and document effectiveness and efficiency of existing systems and develop strategies for improving or further leveraging systems

Manage the reimbursement review. Identify and design appropriate changes. Lead the development and execution of test plans and scenarios for all reimbursement designs for core business system and related processes

Audit configuration to ensure accuracy and internal controls to minimize fraud and abuse and overpayment related issues

Anticipate and identify customer needs and match products and services to facilitate the fulfillment of those needs

Ensure system processes and documents exist as basis for system logic

Manage resources and communications to facilitate work completion

Mentor the use of tools to define requirements

Perform any other job related instructions as requested.

Required Competencies

Exceptional computer skills and abilities in Facets

Advanced proficiency Microsoft Suite to include Word, Excel, Access and Visio

Proven understanding of database relationships required

Understanding of DRG and APC reimbursement methods

Understanding of CPT, HCPCs and ICD-CM Codes

Knowledge of HIPAA Transaction Codes

Effective listening and critical thinking skills

Effective problem solving skills with attention to detail Excellent written and verbal communication skills Ability to work independently and within a team environment

Strong interpersonal skills and high level of professionalism

Ability to develop, prioritize and accomplish goals

Understanding of the healthcare field and knowledge of Medicaid and Medicare

Proper medical coding knowledge and claims processing skills

Customer service oriented

Facets knowledge/training

Ability to manage vendor relationships

Eight Eleven Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, national origin, age, sex, citizenship, disability, genetic information, gender, sexual orientation, gender identity, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state, and local laws.

Skills:
Sr. Configuration Analyst (Remote)
Contract


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VIEW JOBS 12/7/2018 12:00:00 AM 2019-03-07T00:00 Role and Responsibility: * Manage and define system configuration requirements. Responsibility for requirements, definition, document, design, testing, training and implementation support using appropriate templates or analysis tool * Develop and utilize reports to analyze and stratify data in order to address gaps and provide answers to issues identified within the department or by other departments * Identify, manage and document the status of open issues, configuration design, and final resolution within change management system * Review and interpret regulatory items, timely delivery of required updates * Development of standard code set and reimbursement design templates * Plan and implement new software releases including testing and training * Participate in meetings with business owners, users and IT to achieve solutions that meet the requirements and expectation of CareSource Lead configuration initiatives in payment policy meetings and present to committees * Coordinate annual benefit changes with internal resources * Provide analysis of efficiencies related to system enhancement and automation. Review, analyze, and document effectiveness and efficiency of existing systems and develop strategies for improving or further leveraging systems * Manage the reimbursement review. Identify and design appropriate changes. Lead the development and execution of test plans and scenarios for all reimbursement designs for core business system and related processes * Audit configuration to ensure accuracy and internal controls to minimize fraud and abuse and overpayment related issues * Anticipate and identify customer needs and match products and services to facilitate the fulfillment of those needs * Ensure system processes and documents exist as basis for system logic * Manage resources and communications to facilitate work completion * Mentor the use of tools to define requirements * Perform any other job related instructions as requested Requirements Education / Experience: * High School Diploma or GED is required * Bachelor's degree or equivalent years of relevant work experience is preferred * A minimum of five (5) years of health plan experience, to include three (3) years of configuration or clinical editing software experience is required * Exposure to Facets or equivalent system is preferred Required Competencies / Knowledge / Skills: * Exceptional computer skills and abilities in Facets * Advanced proficiency Microsoft Suite to include Word, Excel, Access and Visio * Proven understanding of database relationships required * Understanding of DRG and APC reimbursement methods * Understanding of CPT, HCPCs and ICD-CM Codes * Knowledge of HIPAA Transaction Codes * Effective listening and critical thinking skills * Effective problem solving skills with attention to detail Excellent written and verbal communication skills Ability to work independently and within a team environment * Strong interpersonal skills and high level of professionalism * Ability to develop, prioritize and accomplish goals * Understanding of the healthcare field and knowledge of Medicaid and Medicare * Proper medical coding knowledge and claims processing skills * Customer service oriented * Facets knowledge/training * Ability to manage vendor relationships Licensure / Certification: * Certified Medical Coder (CPC) is preferred Working Conditions: * General office environment, may be required to sit/stand for long periods of time Apply On-lineSend This Job to a Friend Copyright © Ultimate Software Caresource Dayton OH

Sr. Configuration Analyst (Remote)

Expired Job

Brooksource