Claims Systems Configuration Associate Analyst

📋 Description

• The Configuration Associate will perform tasks with support from a mentor and/or the Claims Configuration Supervisor as needed.

• Utilize the Enterprise Jira platform and project methodologies to manage and maintain tickets for claim system configuration requests.

• Claims system configuration requests will encompass proprietary claim edits, industry-standard claim edits, and benefit rules applicable to all claim products and programs.

• You will review, coordinate, and outline changes to the claims system configuration to ensure they meet the required specifications.

• Document configuration modifications in a Microsoft Excel checklist to verify changes.

• Test configuration alterations to ensure claims are processed in line with the established requirements.

• Leverage SQL queries to analyze configuration and claims data.

• Update configurations using the Access database.

• Conduct a post-production review of claims to confirm that the changes deployed to production are functioning as expected.

• Investigate claim processing issues to identify the root cause of claim configuration problems.

⛳️ Requirements

• A high school diploma or GED is required; an associate degree in a computer-related field is preferred.

• A minimum of two (2) years of experience working with claims or healthcare data is necessary.

• At least one (1) year of experience in configuring medical claims systems is required.

• Proven ability to write and execute basic queries using Microsoft SQL Server is essential.

• A minimum of one (1) year of experience with Microsoft Access database, including data manipulation, is required.

• Proficiency in Microsoft Excel, including the use of pivot tables, formulas, and charts, is preferred.

• Strong technical aptitude demonstrated through critical thinking skills and excellent communication abilities is essential.

🏝️ Benefits

• Medical

• Vision

• Dental

• Well-being and behavioral health programs

• 401(k)

• Company paid life insurance

• Tuition reimbursement

• A minimum of 18 days of paid time off per year

• Paid holidays