Molina Healthcare-posted 7 months ago
$77,969 - $141,371/Yr
Seattle, WA
Insurance Carriers and Related Activities

Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements.

  • Implement and maintain critical information on claims databases.
  • Synchronize data among operational and claims systems.
  • Apply business rules as they pertain to each database.
  • Validate data for adherence to business and system requirements.
  • Load and maintain contract, benefit or reference table information into the claim payment system.
  • Participate in defect resolution for assigned components.
  • Assist with development of configuration standards and best practices.
  • Suggest improvement processes for system efficiency and quality.
  • Assist in planning and coordination of application upgrades and releases.
  • Participate in the implementation and conversion of new and existing health plans.
  • Bachelor's Degree or equivalent combination of education and experience.
  • 5-7 years of Configuration experience.
  • Experience working with QNXT, benefits and contract configuration and amendments.
  • Experience working with SQL.
  • Graduate Degree or equivalent experience.
  • 7-9 years of Configuration experience.
  • Experience working with Networx.
  • Competitive benefits and compensation package.
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