Professional, Group Configuration and Billing Analyst

MVP Health Care

20h

About The Position

Join Us in Shaping the Future of Health Care At MVP Health Care, we’re on a mission to create a healthier future for everyone. That means embracing innovation, championing equity, and continuously improving how we serve our communities. Our team is powered by people who are curious, humble, and committed to making a difference—every interaction, every day. We’ve been putting people first for over 40 years, offering high-quality health plans across New York and Vermont and partnering with forward-thinking organizations to deliver more personalized, equitable, and accessible care. As a not-for-profit, we invest in what matters most: our customers, our communities, and our team. What’s in it for you: Growth opportunities to uplevel your career A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team Competitive compensation and comprehensive benefits focused on well-being An opportunity to shape the future of health care by joining a team recognized as a Best Place to Work For in the NY Capital District, one of the Best Companies to Work For in New York, and an Inclusive Workplace. You’ll contribute to our humble pursuit of excellence by bringing curiosity to spark innovation, humility to collaborate as a team, and a deep commitment to being the difference for our customers. Your role will reflect our shared goal of enhancing health care delivery and building healthier, more vibrant communities.

Requirements

Minimum Education: Bachelor of Science in Computer Science, Healthcare Administration, Business Management, or a related field. Equivalent experience in a healthcare organization is also accepted.
Minimum Experience: Experience in utilizing query tools to extract data from relational databases i.e. SQL or advanced Access.
Expertise in the maintenance of mapping tables to drive group setup and configuration.
A strong focus on FACETS billing expertise preferred.
Exceptional critical thinking and problem-solving skills.
Ability to manage multiple assignments with a high level of autonomy and independence.
Demonstrated skills in Microsoft Excel and relational databases.
Strong analytical ability.
Excellent organizational and communication skills.
Strong elements of quality assurance testing expertise.

Responsibilities

Develop and implement configuration in the Cognizant/Trizetto Facets system, emphasizing FACETS configuration and billing expertise.
Support routine enrollment from a group setup and configuration perspective for all product lines.
Support routine billing runs, ensuring accuracy and efficiency in billing processes assist in billing error research.
Analyze inbound requests, incorporating an in-depth understanding of plans and benefits, before implementing the appropriate configuration. Where appropriate work with Sales and other stakeholder groups.
Collaborate with cross-functional teams to comprehend business requirements, ensuring transparent communication across departments.
Ensure the correct cadence of processes is followed, leading to accurate group and customer enrollment, billing, and claims processing.
Perform root cause analysis for issues related to group setup, billing discrepancies, and enrollment challenges, fully mitigating issues to prevent replication.
Create and maintain pre- and post-validation reports/queries to proactively discover group setup and billing issues, iterating processes for issue identification.
Review system enhancements and industry trends, incorporating FACETS best practices for continuous improvement.
Develop and maintain accurate process and policy documents related to group configuration, enrollment, and billing.
Participate in the development and implementation of strategies for corporate and departmental projects.
Prepare detailed analyses and reports for internal customers, emphasizing billing data and trends.
Maintain detailed documentation related to work assignments to support audit processes.
Utilize relational databases used to facilitate configuration, enrollment, billing implementation, and testing.
Assist with test plan creation, test case scenarios, and detailed test scripts, emphasizing quality assurance.
Identify and communicate configuration defects.
Represent the department on committees and project teams.
Perform other duties as assigned.