Critical role: Configuration Analyst Location: Jefferson City, Missouri(Day 1 onsite) Duration: Fulltime Job description: The Configuration Analyst is responsible for designing, configuring, testing, implementation and maintenance of HealthRules Payor pricing, claims and/or benefit configuration, according to business requirements, to support accurate and efficient claims processing and data reporting to meet the needs of the Company.
Investigate and resolve configuration-related provider, member and claim processing issues and assist other departments in understanding HealthRules Payor configuration.
Lead and/or be part of complex HealthRules Payor Implementation and/or configuration projects.
This position must possess strong analytical skills, with the ability to perform complex business rules set up in a fast-pace environment.
The Configuration Analyst serves as a subject matter expert (SME) on both internal initiatives and external customer projects that require configuration modifications within the claims processing system.
Responsibilities: Design, Develop, Configure and Test HealthRules Payor configuration, contracts, products, and policies to Implement HealthRules Payor and migrate the current Core Claims Processing system to HRP.
Analyze, configure, test, implement and maintain HealthRules Payor to support changes in contracts, products, legislation, policies, and procedures, ensuring timely maintenance and updates of configuration.
Test, implement and train on new HealthRules Payor and third party product releases, modules and updates.
Assist in the development of test scenarios for changes and/or projects.
Manage the timely resolution of open testing bugs and issues.
Develop and monitor postproduction audit reports to ensure the intent of change and/or project requirements is being met.
Develop and maintain configuration documentation and communicate changes, as appropriate.
Work with Business Users, Technical team and QA to create detailed functional requirements that support and align to business requirements and testing scenarios.
Research and respond to service requests in a prompt and timely manner and update or build configuration in HealthRules Payor as needed.
Recommend and draft new and updated procedures to maximize the use of HealthRules Payor and other third-party products to improve efficiency.
Inform leader and peers of changes that will impact Company's Medicaid business.
Research and recommend methods to improve or implement necessary changes in a prompt and efficient manner.
Other projects and duties as assigned.
Experience/skills: Minimum requirements: Minimum of 3 years of experience in payer operations, claim processing, and experience deploying HealthRules Payor software.
Minimum of 3 years of hands-on configuration experience in HealthEdge's HealthRules software.
Must possess working knowledge of Medicaid operations, system development and testing.
Expertise in using Microsoft Office; including Excel, Word, Access, Power Point, and Visio.
Experience working within a matrix organization.
Excellent oral and written communication skills and the ability to interface with all levels of the customer organization.
Preferred requirement: Previous experience with CMS and State Medicaid Agencies Knowledge of or experience with ClaimXten, Axiom TranSend, and Axiom TransShuttle.