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Benefit Configuration Analyst

MetroPlusHealth -
New York, NY

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Job Details

$85,000 - $95,000 a year
7 days ago

Qualifications

Configuration management
Medical claims processing software

Full Job Description

Position Overview

The Benefit Configuration Analyst will be responsible for constructing the Claims Processing Systems to process new enrollments. Experienced candidates must demonstrate working understanding of claims processing systems and
working knowledge of the health care industry.

Scope of Role & Responsibilities

Configure MHP’s core systems to meet regulatory requirements and business needs.
Meet with business areas to gather configuration requirements.
Create and maintain Core Systems user guide related to configuration changes.
Create and maintain Core Systems user guide related to configuration changes.
Test system modifications and configuration changes.
Analyze business process to improve efficiencies.
Create templates on benefits to track current configuration.
Ensure system processes and services are aligned with the department’s need.
Analyze the system to ensure claims are processed correctly to prevent the company from liabilities.
Collaborate with MetroPlusHealth system consultants to correct errors, rectify omissions, and investigate questionable issues.
Identify potential system problems for claims resolution.
Analyze business processes, gather the requirements, and document the requirements in line with the strategic initiative
Review test cases making sure they are in accordance with requirements and assist the overall testing process.
Conduct ongoing reviews of systems and processes to ensure accurate and optimum setup for claims.
Attend meetings with managers regarding process plans, functionality, and business processes.
Receive, coordinate, and manage requests for Systems Modifications
Maintain and track open issues and coordinate releasing testing
Document policies and procedures
Ability to run reports utilizing sequel
Monitor and Manage Core Systems performance
Respond to escalated issues from various MetroPlusHealth Departments.
Perform and assist with any other functions as required by the Director of Core Systems Operations

Required Education, Training & Professional Experience

A Baccalaureate Degree from an accredited college or university; and
Five (5) years of progressive, responsible experience in configuration for data processing, computer systems and applications; or
A satisfactory equivalent combination of training, education and experience.

Professional Competencies

Integrity and Trust
Customer Focus
Functional/Technical skills
Written/Oral Communication

#LI-Hybrid

#MHP50

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Benefit Configuration Analyst

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