Gravie
We partner with brokers across the nation to improve the way people purchase and access healthcare.
Senior Configuration Analyst
Location
United States
Posted
2 days ago
Salary
$60.7K - $101.1K / year
Bachelor Degree8 yrs expEnglish
Job Description
• Analyze benefit plan documents to accurately build benefit categories and adjudication rules to accurately and efficiently process claims
• Be a leader on the configuration team by supporting training, process development, and peer review / QA.
• Support cross-functional teams during implementations/renewals and develop solutions for plan variations.
• Provide support to team members for escalations and complex configuration requests.
• Perform root causes analysis of adjudication logic and benefit defects.
• Support special project implementations as required
• Create and update policies and procedures and other documentation of our accumulators and plan configurations.
• Perform quality reviews, regression and functional testing in support of configuration changes and application updates.
• Demonstrate commitment to our core competencies of being authentic, curious, creative, empathetic and outcome oriented.
Job Requirements
- 3+ years configuring accumulators and benefit plans or other related experience in payer business logic.
- 5+ years of experience as a claims examiner, coder, or other related experience working with medical claims data.
- Experience with adjudication processes, analyzing plan designs, and health plan information systems and applications.
- Knowledge/experience with self-funded, level-funded plan designs.
- Ability to set priorities, manage time, and work independently.
- Demonstrated success getting results through collaboration.
- Extra credit:
- Familiarity with the mPhasis, Eldorado, Javelina claims processing software.
- Working knowledge of EDI formats (837/835 claims, 270/271 eligibility) and coding systems (CPT/HCPCS, ICD, DRG).
- Experience in rapidly-growing start-up business environments.
- Understand file types A37, 270, 271, 276, 277, 278 experience.
Related Guides
Related Categories
Related Job Pages
More Analyst Jobs
Analyst2 days ago
Full TimeRemoteTeam 1,001-5,000H1B No Sponsor
Director of Analyst Relations at Intermedia leading global engagement strategy
Cloud
California
Analyst2 days ago
Full TimeRemoteTeam 10,001+Since 1978H1B No Sponsor
Analyst managing workforce operations for a global business services company
Michigan
Analyst2 days ago
Full TimeRemoteTeam 10,001+Since 2020H1B No Sponsor
Analyst for Supplier Quality at Pratt & Whitney ensuring compliance.
United States
SAP Transportation Management, TM Analyst
iHerb, LLCCome join the movement....we are a vehicle to healthy living!
Analyst2 days ago
Full TimeRemoteTeam 1,001-5,000Since 1996H1B No Sponsor
SAP TM Analyst supporting transportation planning processes for e-commerce digital operations