The System Configuration Analyst helps Curative to ensure that our claims systems are performing optimally by analyzing requirements and building configuration with the claims system to meet those requirements. The role depends on a strong working knowledge of healthcare processes including eligibility, benefits, provider setup, and provider contracts and fee schedules.
Our team is remote, and we’re dedicated to creating an ambitious and diverse organization to represent and support the patients we serve.
Finally it's important to us that everyone on our team be prepared to work with and supportive of a variety of backgrounds, roles, and needs. Our organization is built on trust and mutual respect, we know that it's only together that we achieve truly great things.
Responsibilities
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Review business requirements, including requirements defined within benefit plan documents, provider contracts, and other sources.
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Create system configuration within the claims system to meet the defined requirements
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Perform initial testing of configuration to validate accuracy of the configuration
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Support troubleshooting efforts when issues are identified or reporting
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Recommend improvements to configuration processes and designs in order to reduce long-term maintenance and costs and improve automation and accuracy
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Review claims system release notes to understand new functionality and make recommendations for how to utilize new and improved claims systems features
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This role involves significant hands-on configuration of the claims system including creation and modification of benefits, benefit plans, service categories, provider contracts, fee schedules, and provider data set up
Please reach out if this describes your experience
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5+ years of working within a healthcare payer environment in Operations or Technology
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3+ years of experience working hands-on with HealthRules Payer required in a configuration capacity including benefit, contract, fee schedule, account, and/or provider configuration roles
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Knowledge of healthcare claims processing including adjudication, pricing, benefit management, and provider contracting, and pricing methodologies (Medicare Professional, IPPS/OPPS methodologies, etc.)
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Demonstrated expertise with common tools such as MS Word, MS Excel