Configuration Analyst I

MISSIONOur 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.VALUESHealthOne 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 PURPOSEThe 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 DUTIESAssists with the dictionary/master file maintenance such as research, set up and maintenance of all Diagnosis, CPT, and other medical code setsAssists with updates and maintains adjudication system with defined code sets in logical orderCoordinates with internal departments to ensure data accuracySupports maintenance of group/benefit additions, terms, changesAssists in the support fee schedule maintenance including terms, affiliations, and contract maintenanceRuns existing testing scripts for new and existing plansAssists in the on-going evaluation of the benefit configurations within the core claim processing system for new and existing benefit plansDocuments the configuration of new plans as well as changes in existing plansProvides feedback to Configuration Analyst II regarding feasibility and requirements for enhancements to benefit configurationProvides research assistance for the resolutions of benefit issuesServes as a liaison of benefit configuration to external departmentsCollects and analyzes data to evaluate operational difficulties and makes recommendations to solve problemsSupports the work to troubleshoot and resolves claims that suspend in work queues for configuration intervention in the claims processing systemAudits files and/or batch load entries for accuracyAssists in problem solving of the monthly files such as 837 Encounter File submissions and error correctionsPerforms a variety of tasks related to the on-going maintenance and set up of client configurations with the core administrative systemAssists with client implementations, system upgrades and projects to improve performanceParticipates in problem solving of provider, client, reporting or system issuesPotential to rotate through configuration support functions across key system areas and lines of business with the ability to develop subject matter expertisePerforms special projects as needed and other duties related to system and report data integrityMaintains regular and predictable attendanceConsistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practiceWorks to encourage and promote Company culture throughout the organizationOther duties as may be assignedQUALIFICATIONSHigh School Diploma or GED requiredAssociates or Bachelor's degree in a business or computer-related field preferredKnowledge of ICD-10, CPT4 Coding, HCPCS and medical terminologyThree or more years of Healthcare experienceThree 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 BillingCoding Certificate preferredProficiency in Microsoft Office Suite including Outlook, Word, Excel, and PowerPointPHYSICAL REQUIREMENTSProlonged 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.BENEFITS401K (4% Match, Immediate Vesting)Accident insuranceCompetitive salaryCritical Illness InsuranceDental InsuranceEmployee Assistance ProgramFlexible Spending AccountHealth & Wellness ProgramHealth Savings AccountLife & AD&D InsuranceLong Term DisabilityMedical InsurancePaid Time OffPet InsuranceShort Term DisabilityVision InsurancePRE-EMPLOYMENT SCREENINGDrug Screen and Background Check RequiredHEALTHONE IS AN EQUAL OPPORTUNITY EMPLOYERAll 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.