Configuration Analyst

Versant Health•Troy, NY

About The Position

The Configuration Analyst is responsible for activities related to major system configuration, new health plan implementations, and conversions. Additionally, this role is responsible for the ongoing maintenance and set-up within the health benefits administration systems. The Configuration Analyst configures vision benefit programs in the Health Solutions Plus, HSP, platform and other integrated systems that support client program requirements gathered through the sales process using innovative thinking to maximize system capabilities.

Requirements

3-5 years of experience in the Healthcare or Health Insurance field required
HIPAA & Security Requirements
All Associates must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures.
As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be always protected.
As a result, Associates must explicitly adhere to all data security guidelines established within the Company’s Privacy & Security Training Program.

Nice To Haves

Bachelors degree preferred

Responsibilities

Configure and maintain the claim processing system mapping and all interface modules
Analyze business rules associated with claim payment, adjudication, and benefit administration/provider reimbursement
Maintain Benefit Plan mapping parameters throughout the system; create, test and maintain Benefit Plan additions, terms and changes
Implement claim system upgrades which improve communication logic within the system processes
Involved in company configuration of all new client and provider implementations
Follow detailed setup procedures in complex claims/benefit plan systems
Develop and follow Quality Assurance and Quality Control procedures to maintain configuration accuracy and consistency
Monitor department compliance measures from the Annual SSAE-16 Audit
Provide direct support to all areas of the company regarding benefit plans, new group setup and maintenance, workflows, user defined tables and related structures
Advise end users in planning and implementing new products as they relate to HSP functionality and configuration
Maintain dictionary/master files, including but not limited to research, set-up and maintenance of all diagnosis, CPT and other medical codes as identified
Perform peer-to-peer level quality review and test procedures to ensure all components of benefit programs are correct
Participate in departmental, ad-hoc, and interactive onsite meetings as designated
Perform other duties as assigned