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Configuration Analyst

4.00 to 9.00 Years   Pune   04 May, 2020
Valence Health
Job LocationPune
EducationNot Mentioned
SalaryNot Disclosed
IndustryMedical / Healthcare
Functional AreaGeneral / Other SoftwareNetwork / System Administration
EmploymentTypeFull-time

Job Description

Position summary Evolent is looking for motivated and engaged individuals to join the Configuration Team in Health Plan Services. If you have a penchant for detail, are a recent college graduate or have prior health insurance claims processing or configuration experience, we would like to talk with you! We will train the right candidates for this position.Essential functions Collaborate with business and technical teammates to resolve client production issues

  • Participate in problem solving of Health Plan benefit, provider, pricing, reporting, operational and system issues
  • Perform a variety of tasks related to the resolution of production support issues based on client configurations with the core administrative system
  • Potential to rotate through configuration support functions across key system areas and lines of business with the ability to develop subject matter expertise
  • Support the work to troubleshoot and resolve claims issues introduced by user, configuration, system or reporting errors; working multiple issues simultaneously
  • Support activities to update configuration within the core claims processing system, typically within the areas of Provider, Pricing or Benefit Plan/Adjudication Rules. Potential responsibilities include and may vary by system area of assignment:
  • Update credentialing variables and demographics (credentialed and non-credentialed providers), contract or fee schedule assignment and network affiliation
  • Update group/benefit configuration including benefit plans (coinsurance, deductible, copay, out of pocket) and benefit plan rules
  • Support fee schedule changes including terms, affiliations and contract maintenance
  • Updates to general system configuration such as workflow, dictionary/master file updates (research, set up and maintenance of reference values (diagnosis codes, procedure codes, 835 CARC/RARC and other medical codes) and global settings, as necessary
  • Collaborate across IT and Operational departments to define and develop necessary technology or business processes to support process improvement initiatives
,

Keyskills :
productionsupport problemsolving subjectmatterexpertise processimprovement systemconfiguration delivery claims benefitsadministration customerrelations configurationmanagement sql insuranceclaims claimsprocessing codes healthinsurance proce

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