Contract Configuration Analyst I

Advanced Medical Management • Long Beach, CA

72d

About The Position

The Configuration Analyst I will be responsible for supporting all aspects of system configuration ensuring that all system configurations are programmed accurately for Authorizations and Claims.

Requirements

• Minimum 5 years’ of administrative healthcare experience preferred.
• High School Diploma or GED, some college preferred.
• Experience with benefits and system configuration and interpretation.
• Medical terminology, CPT, Revenue codes, ICD10, RBRVS, HCPCS, HIPPS code sets.
• Must have experience with all lines of business, Medicare, Medi-Cal, and Commercial claims and know industry guidelines.
• Knowledge of software applications such as EZCAP is a plus.
• Must be familiar with Microsoft Office (Word, Excel, Outlook, Microsoft Access, SQL).
• Follow up on assignments, show initiative, be self-motivated, and have a strong work ethic.
• Possess strong time management skills, including the ability to prioritize deadlines on multiple projects.
• Produce accurate and high-quality work on time and consistently.
• Individual should also demonstrate the ability to work with all levels of staff within AMM.
• Must be highly organized and able to perform multiple tasks efficiently, be computer literate.
• Ability to work in a fast-paced environment.
• Strong analytical skills and problem solving skills are necessary.
• Must obtain a positive attitude and have excellent communication skills.

Nice To Haves

• Experience with EZCAP software.

Responsibilities

• Configure rates based on provider contracts to ensure accurate payments of claims and capitations to providers.
• Configure rates based on vendor contracts to ensure accurate payments.
• Maintain system configuration based on data received from contracting.
• Audit accuracy of Fee schedules in test environment prior to in-loading in production.
• Assign Fee Set Assignments by line of business or health plan code.
• Program and audit Interest Payment.
• Program and audit RBRVS Geographical Adjustment.
• Apply previous experience and knowledge to research and resolve claim/encounter issues, pended claims and update system as necessary.
• Coordinating with internal departments to resolve and assist with system related issues/builds.
• Other duties may be assigned by the Supervisor of Contract Configuration or Manager of Contract Configuration.
• Ability to handle fluctuating volumes of work and be able to prioritize work to meet deadlines and needs of user community.

Benefits

• Full employer-paid HMO and the option for a flexible PPO plan.
• Discounted vision and dental premiums.
• FSAs to manage healthcare and dependent care costs.
• 401(k) to secure your future.
• Generous PTO, 40 hours of sick pay, and 13 paid holidays.
• Tuition reimbursement to support your education and growth.
• Paid company outings and lunches.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 51-100 employees