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Configuration Analyst
Posted 12 days agoViewed
💎 Seniority level: Middle, 3+ years
🔍 Industry: Healthcare
🏢 Company: Abarca Health👥 501-1000Information TechnologyHealth Care
⏳ Experience: 3+ years
Requirements:
- 3+ years of work-related experience benefit plan configuration and/or implementations.
- Experience working with SQL and Excel tools.
- Ability to establish good interpersonal skills.
- Excellent oral and written communication skills.
Responsibilities:
- Primary support for on plan configuration setup for new Medicare, Medicaid, Commercial and Employer client implementations, as well as configuration changes for existing clients.
- Perform unit testing to confirm configuration set-up or changes are processing as expected as defined in the client documentation.
- Perform Quality Control and Quality Assurance functions to assess information accuracy in all configuration processes.
- Perform research and resolution of adjudication and processing issues including, identification of root cause, impact analysis determination and corrective action.
- Resolution & Ownership of project-based work as assigned.
- Provide first-tier triage support within SLAs/SLOs to verify and analyze pharmacy claims processing case research referred for validation.
- Collaborate and coordinate both within the configuration teams and with other business units to execute configuration as required.
- Responsible for daily tracking and monitoring of assigned requests to ensure due dates are met
- Support the review, impact analysis, root cause assessment and preventive measures for issue management related workload.
- Continuously develop and maintain an in-depth understanding of Darwin (proprietary adjudication platform) system logics to ensure benefit designs are configured to meet client requirements with accuracy.
- Stay current with external regulator guidelines such as Medicare, Medicaid, and state requirements, to make timely adjustments to operations ensuring our processes follow compliance, rules, and regulations.
- Provide consultation and peer review for configuration practices and design.
- Identify functionality needed to achieve client outcomes and collaborate with product and adjudication teams to plan and deliver appropriately.
- Support the Sr. Analyst in documenting client plan standards.
- Support in development of process documentation, including Policies and Procedures, to document Darwin Configuration operational processes.
- Evaluate and analyze configuration processes and make recommendations for improvements.
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🏢 Company: Abarca Health👥 501-1000Information TechnologyHealth Care
- Associate or Bachelor’s degree in Accounting, Finance, or related field.
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- Perform unit testing to confirm configuration set-up or changes are processing as expected as defined in the client documentation.
- Perform research and resolution of adjudication and processing issues including, identification of root cause, impact analysis determination and corrective action.
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- Support the review, impact analysis, root cause assessment and preventive measures for issue management related workload.
- Continuously develop an understanding of Darwin (proprietary adjudication platform) system logics to ensure benefit designs are configured to meet client requirements with accuracy.
- Make timely adjustments to operations ensuring our processes follow compliance, rules, and regulations of Medicare, Medicaid and State Requirements.
- Collaborate and coordinate with other business units to execute configuration as required.
- Provide feedback on processes and make recommendations for improvements.
Posted 12 days ago
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