Configuration Specialist

CDPHP and its family of companies are mission-driven organizations that support the health and well-being of our customers and the communities we are proud to serve. CDPHP was founded in Albany in 1984 as a physician-guided not-for-profit, and currently offers health plans in 29 counties in New York state. The company values integrity, diversity, and innovation, and its corporate culture supports those values wholeheartedly. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.

This individual works with the Architect, Analysts, Developers, Project Managers, Managers and Director to play an integral part within the Configuration department to support CDPHP's core processes, projects, audits & regulatory reporting, defects, and incidents by reviewing, analyzing, and configuring provider data. The Configuration Specialist provides support to projects and produces the deliverables associated with analysis, pended claims queue; benefit & provider configuration and defects and incidents; including running all claims impact reports.

This position is responsible for Peer Review and Unit Testing, along with oversight and follow-up with internal customers and/or external vendors, and assurance that all Production deploys are successfully integrated and completed. This individual will work with the Quality Analyst, Manager, Configuration, Manager, Provider Reimbursement-Configuration and the Director, Configuration on an ongoing basis to review, monitor, and follow-up & fix quality findings, along with overall quality control reports.

This Configuration Specialist is expected to demonstrate a working knowledge in healthcare and HMO processes and rules, including providers, benefits, pricing, enrollment, payment and claims. Individual should be capable of meeting with business stakeholders in the Claims Operations departments and demonstrate a clear understanding of that area's relationship to the operational structure and application user interaction.

QUALIFICATIONS:

• High school diploma or GED required. Associates degree preferred.
• Minimum three (3) years Health Insurance and/or Facets required.
• Experience in configuration, testing and troubleshooting issues that support division-specific functions is required.
• Minimum of two (2) years of experience working with health insurance billing and enrollment systems is preferred.
• Knowledge of healthcare and HMO processes, rules, regulations, enrollment/eligibility guidelines, and reporting requirements for HMO, PPO, ASO, Medicare, Medicaid, Family Health Plus, and Child Health Plus.
• A demonstrated ability to analyze, identify, implement, and monitor outcomes is required.
• A demonstrated ability to manage and shift priorities to meet project schedules is required.
• An ability to successfully work with the Configuration Team in defining system implementation, conversion, and configuration strategies is required.
• Proficiency in Microsoft Excel is required. Proficiency with Access and SQL is preferred.
• Experience with Ingenix or PPS (Prospective Payer System) preferred.
• Excellent written and verbal communication as well as strong analytical skills are required.
• Excellent organizational and interpersonal skills are required.
• An ability to be a productive team player is required.

Hourly salary range: $24.00 - $29.00

CDPHP salary ranges are designed to be competitive with room for professional and financial growth. Individual compensation is based on several factors unique to each candidate, such as work experience, qualifications, and skills. In addition to cash compensation, CDPHP employees may be eligible for an incentive payment, a discretionary cash reward based on employee and company performance. Some roles may also be eligible for overtime pay.

CDPHP compensation packages go far beyond just salary. The company offers a comprehensive total rewards package that includes award-winning health care coverage, health care dollars, a generous paid time off allowance, employee assistance programs, flexible work environment, and much more. Learn about all CDPHP employee benefits here.

As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices on the basis of race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, protected veterans status, or any other characteristics protected under applicable law. To that end, all qualified applicants will receive consideration for employment without regard to any such protected status.

CDPHP and its family of companies include subsidiaries Acuitas Health LLC, Strategic Solutions Management Consultants (SSMC), Practice Support Services (PSS), and ConnectRX Services, LLC.