Configuration - Configuration Specialist 200-1003

JOB SUMMARY:

Responsible for developing business requirements and proposed solutions to meet contract requirements.

KEY RESPONSIBILITIES:

• Continued development, maintenance and support of related modules and interfaces with the Healthcare system.
• Investigate and resolve claims that do not map to a price or benefit authorization.
• Assist with development of and conducts testing for new modules.
• Responsible for testing pricing configuration and new modules.
• Conducts training on new system functionality.
• Perform other duties as assigned.

QUALIFICATIONS:

• Clear understanding of ICD9, CPT coding and medical terminology.
• Ability to perform detailed mathematical calculations and strong understanding of mathematical concepts and skills in abstract reasoning.
• Successful completion of Health Care Sanctions background check. Highly organized and attentive to details.
• Ability to manage multiple tasks simultaneously.
• Ability to communicate technical information to users in concise understandable terms and user information to technical staff.
• Ability to manage multiple task simultaneously work independently with minimal supervision and meet stringent deadlines.
• Excellent problem solving and organization skills.
• Ability to read, process, and understand complex benefit information and contractual agreements.
• Ability to interact with personnel at all levels.
• Proficient in Microsoft applications.

EDUCATION/EXPERIENCE:

• Bachelor degree OR one year of related work experience can be substituted for each year of college not completed AND minimum four years of experience in a health care environment.
• Minimum of two years working experience with benefits and/or pricing in insurance environment.
• Minimum one year of business analyst experience preferred.

CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin

Other details

• Job Family Commercial
• Pay Type Hourly

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