Configuration Analyst I

    • Job Tracking ID: 512935-571953
    • Job Location: Meridian, ID
    • Job Level: Mid Career (2+ years)
    • Level of Education: Any
    • Job Type: Full-Time/Regular
    • Date Updated: April 12, 2017
    • Years of Experience: Up to 2 Years
    • Starting Date: April 24, 2017
    • Salary Type:: Hourly
    • Rate:: $15.23
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Job Description:

Job Summary

This position works in our Plan Build Department maintaining system configuration used to process claims in the GBAS operating system.

Successful candidates will have experience in Medical Claims Adjudication, Claim Benefits, Provider Updates, and Customer Care systems, or related claims processes,

and will have experience in Medical Claims processing, coding and/or customer service experience for a minimum of one year in the Third-Party Administrator (TPA) business.

Key Result Areas

Essential

  • Administer plan benefits based on documentation received.

  • Participate in plan implementation with key departments such as Administration, Claims, Customer Care, and Account Management.

  • Play an active role in plan administration by providing technical support for multiple departments.

  • Identify and expedite issues regarding plan design and interpretation of benefits to appropriate management personnel. Respond to 1st and 2nd level-escalation claim issues within 24-48 hours.

  • Work route QUE on a daily basis, adherence to 24-48-hour turnaround.

  • Regularly update and maintain tables essential for claims adjudication i.e. PDCRM, ACNM, AAPM, AC, CFEEM, and many more.

  • Perform integrated audit and/or pre and post testing on plan design, networks, and implementations.

  • Enter plan information accurately and efficiently into the claims system.

Additional

  • Ability to identify problems with Plan set-up.

  • Performs other related duties as assigned or needed.

Experience and Skills:

Minimum Qualifications

  • 2 years’ experience in Claims Adjudication, Claim Benefits, Provider Update, and Customer Care systems, or related claims processes.

  • Claims processing, coding and/or customer service experience for a minimum of one year in the TPA business

  • Knowledge of CPT, diagnosis, HCPC, and UB92 revenue coding and ability to use technical experience to make decisions regarding plan changes.

  • Ability to read and understand plan benefits

  • Ability to work efficiently, multi-task, prioritize tasks, and meet tight deadlines

  • Knowledge of Microsoft Office and other computer programs/software

  • Requires interpersonal skills to relate to clients and other departments within the company

  • Ability to complete training process in a timely manner

  • Ability to efficiently and effectively perform the Essential Key Result Areas with or without a reasonable accommodation without posing a direct safety threat to others or self

  • Protect and enhance the Core Purpose and the Core Values of the AmeriBen/IEC Group