Configuration Analyst

Curative•Austin, TX

18d•Remote

About The Position

Curative wants to change the view on what a health plan can be. Born out of the pandemic, we created a health plan reinvented for a post-pandemic world that is built around a whole person's affordable preventive care featuring more benefits. Curative is looking for a HealthRules Payer Configuration Analyst who is passionate about helping the company as we work to reinvent healthcare options. Candidates will be able to utilize their previous experience in the medical field by increasing satisfaction and retention by providing Curative health plan members, patients, and providers with accurate, consistent, timely information. They will provide support while building rapport and collaborative relationships with current and prospective members in accordance with compliance guidelines. This is a remote position.

Requirements

3+ years of health plan configuration experience within the HealthRules Payer platform; experience with provider contract configuration using HRL (Health Rules Language).
5+ years of experience in claims processing of all claim types, including hospital/facility, behavioral health, dental, vision, and professional medical claims.
Operational experience in a health plan environment in or more of the following domains: enrollment/eligibility, provider data management, or account installation.
Knowledge of medical terminology, ICD-10, CPT, HCPCS, and revenue codes.
Proficient computer skills to include Microsoft Office applications and Google Suite
Excellent verbal and written communication skills
Ability to sit for extended periods of time at a computer workstation.
Ability to Multitask and think creatively.

Nice To Haves

Familiarity with claim coding and editing rules.
experience with SQL, including understanding and creating queries

Responsibilities

Configure complex professional and facility contracts within the HealthRules Payer system
Configure and maintain HRP configuration for claims, pricing, and benefits
Investigate and resolve configuration issues on the HealthRules Payer system to ensure timely and accurate claims payment and account implementation
Maintain clear and accurate documentation of all configuration activities and decisions
Prepare and execute test cases to validate that configuration changes function as expected
Review and resolve claim pends on a daily basis to ensure claims are processed timely
A team player; perform tasks in a very fast paced environment.
Work on claims team projects and reporting, as assigned.
Attend departmental training when required or requested.
Adhere to the rules and regulations of Curative as described in the Employee Handbook and as defined in the unit/department/clinic procedures.