HealthRules Payer Configuration Analyst
About The Position
HealthEdge is seeking a HealthRules Payer Configuration Analyst to support the daily operations of an assigned client. The role uses expertise in one or more HealthRules Payer modules to manage incidents and tickets, gather business requirements, configure and unit test software, and coordinate configuration work with client and offshore counterparts. The analyst validates offshore configuration through peer reviews and monitors claim impact reports for accuracy and integrity. The position also identifies opportunities to automate processes and reduce manual effort. This is a full-time, permanent role with remote US geographic responsibility. The work involves collaborating across multiple time zones in a hybrid or remote environment, extended periods working at a computer using video technology, and possible travel based on company needs.
Requirements
- At least 2 years of HealthRules Payer configuration experience.
- Experience in at least one HealthRules Payor module, such as Benefits, Pricing, Claims, or Finance.
- Hands-on experience with Pricing and Contracts.
- Strong analytical and problem-solving skills.
- Excellent communication and presentation skills, including the ability to convey business requirements and configuration effectively to clients and offshore team members.
- Detail-oriented, self-starter who is eager to learn and adapt to a fast-paced environment.
Nice To Haves
- Source and Editing experience.
- Experience with Agile methodology.
Responsibilities
- Support daily operations for an assigned client using expertise in HealthRules Payer configuration.
- Interact with clients and offshore counterparts to work tickets and meet client business needs.
- Manage incidents, gather requirements, configure software, and perform unit testing.
- Provide requirements to offshore teams for configuration and validate their work through peer reviews.
- Analyze claim impact reports for reprocessing projects to assess financial impact and ensure analytical accuracy and integrity.
- Monitor claim impact reports for accuracy and integrity.
- Identify process automation opportunities to improve efficiency and reduce manual effort.
- Track tickets and develop plans to remediate issues as needed.
- Work independently and collaboratively to solve and test complex scenarios.
- Comply with the organization's Code of Conduct, regulatory and contractual requirements, policies, procedures, and internal controls.
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
