MISSION
Our mission is to enhance well-being by connecting individuals with vital health resources through a compassionate workforce that embodies the spirit of neighbors helping neighbors.
VALUES
HealthOne is guided by a cultural framework that embodies our values and drives our decisions.
As a company our PURPOSE is to care for people by connecting them to resources that help protect them in health related situations. We fulfill our purpose by filtering our decisions through a PRIORITIES lens of asking, “Is what we are about to do ethical, empathetic, economical, and efficient?”. By caring for PEOPLE, we are welcoming, authentic, truthful, consistent, and humble. We are continuously looking for ways to improve our PROCESS and how we get things done.
HealthOne seeks individuals with integrity and heart to embody our values. Whether you’re starting your career or looking to develop additional skills to reach your full potential, HealthOne provides the means to help you achieve your goals.
JOB PURPOSE
The Configuration Analyst I support activities to maintain data within the core claims processing system using the medical classification system to design the benefit packages with proper code sets, including ICD-10, CPT-4, HCPCS for configuration. Disseminates benefit determinations to key stakeholders administering benefits (health services, configurations, etc.) throughout the organization. Serves as an integral role in the testing, analysis, and benefit configuration of new and existing plans.
ESSENTIAL JOB DUTIES
Assists with the dictionary/master file maintenance such as research, set up and maintenance of all Diagnosis, CPT, and other medical code sets
Assists with updates and maintains adjudication system with defined code sets in logical order
Coordinates with internal departments to ensure data accuracy
Supports maintenance of group/benefit additions, terms, changes
Assists in the support fee schedule maintenance including terms, affiliations, and contract maintenance
Runs existing testing scripts for new and existing plans
Assists in the on-going evaluation of the benefit configurations within the core claim processing system for new and existing benefit plans
Documents the configuration of new plans as well as changes in existing plans
Provides feedback to Configuration Analyst II regarding feasibility and requirements for enhancements to benefit configuration
Provides research assistance for the resolutions of benefit issues
Serves as a liaison of benefit configuration to external departments
Collects and analyzes data to evaluate operational difficulties and makes recommendations to solve problems
Supports the work to troubleshoot and resolves claims that suspend in work queues for configuration intervention in the claims processing system
Audits files and/or batch load entries for accuracy
Assists in problem solving of the monthly files such as 837 Encounter File submissions and error corrections
Performs a variety of tasks related to the on-going maintenance and set up of client configurations with the core administrative system
Assists with client implementations, system upgrades and projects to improve performance
Participates in problem solving of provider, client, reporting or system issues
Potential to rotate through configuration support functions across key system areas and lines of business with the ability to develop subject matter expertise
Performs special projects as needed and other duties related to system and report data integrity
Maintains regular and predictable attendance
Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice
Works to encourage and promote Company culture throughout the organization
Other duties as may be assigned
QUALIFICATIONS
High School Diploma or GED required
Associates or Bachelor's degree in a business or computer-related field preferred
Knowledge of ICD-10, CPT4 Coding, HCPCS and medical terminology
Three or more years of Healthcare experience
Three or more years of working around claims implementation and analysis and/or claims configuration experience in any one of these areas: Provider/Provider Contracting, Clinical Benefits, Enrollment and Billing
Coding Certificate preferred
Proficiency in Microsoft Office Suite including Outlook, Word, Excel, and PowerPoint
PHYSICAL REQUIREMENTS
Prolonged periods of sitting at a desk and working on a computer. Moderate to significant amount of stress in meeting deadlines and dealing with day-to-day responsibilities. Must be able to drive a vehicle and daytime/overnight travel as required.
BENEFITS
401K (4% Match, Immediate Vesting)
Accident insurance
Competitive salary
Critical Illness Insurance
Dental Insurance
Employee Assistance Program
Flexible Spending Account
Health & Wellness Program
Health Savings Account
Life & AD&D Insurance
Long Term Disability
Medical Insurance
Paid Time Off
Pet Insurance
Short Term Disability
Vision Insurance
PRE-EMPLOYMENT SCREENING
Drug Screen and Background Check Required
HEALTHONE IS AN EQUAL OPPORTUNITY EMPLOYER
All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, disability, sex, age, ethnic or national origin, marital status, sexual orientation, gender identity or presentation, pregnancy, genetics, veteran status, or any other status protected by state or federal law.
