Configuration Analyst

» Configuration Analyst
Human Resources
in Tampa
, FL
Reference: 19-02881

Description:

Oversee accurate and timely development of price rules and contract templates. Develop new business plans that will help promote technology and automation.

Key Duties and Responsibilities:

  • Build rules within the Peradigm System, in coordination within state and federal guidelines
  • Monitor and test the accuracy of price rules
  • Research both state and federal mandates and build interpretation grids
  • Build and test contracts and pricing templates for the non-par and new business teams
  • Work with all regions on non-par documentation
  • Train/monitor staff on contract pricing and contract templates
  • Resolve provider load issues within appropriate time
  • Ensure proper supporting documentation and maintain files for all price rules
  • Resolve critical errors forwarded from the claims department
  • Build and maintain positive business relationships with business partners
  • Load professional contracts into the Diamond System through appropriate research and provider data load activities

Education:

  • A Bachelor’s degree in a related field or equivalent work experience

Work Experience:

  • 3+ years of experience in analytics in a related field (required)
  • Prior healthcare experience (preferred)

Skills:

  • Knowledge of claims processing
  • Advanced understanding of contract terms and how they are loaded into the system
  • Advanced knowledge of provider/institutional billing practices
  • Ability to effectively research issues and resolve problems

Technology:

  • ¬†Peradigm (Diamond)
  • ¬†SAS or SQL
  • Cactus systems
  • Knowledge of CPT/HCPCS coding

Level of Supervision Received:

  • Under general supervision, proceeds alone on regular duties, referring questionable cases to supervisor