Knowledge Summary
- Must have a thorough understanding of the configuration of business rules that support reimbursement policies and methodologies, member/provider contracts, and claims adjudication and correspondence.
- Must have demonstrated strong analytical, technical and problem-solving skills.
- Ability to work with multiple business systems and have a good understanding of system design.
- Demonstrated experience in Microsoft office products and project management tools.
- Strong communication and analytical skills required to covey complex technical ideas, concepts and applications.
- Must understand the business environment and associated systems.
- Must be detail oriented and understand corporate objectives.
- Must have the ability to follow through on project life cycles.
- Experience in data analysis, testing and implementation.
- Technical writing skills needed.
- Must be able to present findings to management.
- Must be able to create time-lines and work with internal and external departments to gather appropriate information.
- Skills in coaching and mentoring.
- Works independently on projects, identifies and implements business systems solutions with minimal supervision.
- Good understanding of available resources to investigate, perform testing, analyze and present initial findings.
- Strong presentation skills required.
- Knowledge of project management tools and business system methodology
- Proficiency in Healthcare and Health Plan terminology, medical coding (e.g., CPT, HCPCS, ICD9, CDT, Revenue, DRG and other relevant medical and industry-standard codes)
Education & Experience
- Bachelor's degree in business administration, Management Information Systems, Computer Science or equivalent work experience.
- In lieu of degree, minimum 3-4 years proven configuration experience, preferably on Facets, Health Rules, Diamond, Amisys Advance or similar payer system Strong project management skills needed.
- 2+ years HealthCare operations or Healthcare claims processing experience
Hybrid
Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
