Health Plan Configuration Analyst - National Remote

At reputed company , we’re simplifying the health care experience, creating healthier communities and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care reputed company of reputed company, making it more reputed company, reputed company and reputed company. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together. This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00 AM - 5:00 PM CST. It may be necessary, given the business need, to work occasional overtime or weekends. We offer on the job training. The hours during training will be 8:00 AM - 5:00 PM CST from Monday - Friday. You’ll enjoy the flexibility to telecommute* from reputed company reputed company the U.S. as you take on some tough challenges. reputed company Responsibilities: • Execute the build and implementation of benefit plan adjudication rules • Coordinate the integration or conversion of new clients and / or products as needed, often under aggressive timelines • Participate in the development and implementation of an reputed company claim platform, providing subject matter expertise on the reputed company configuration and usability components • reputed company operational needs with technology requirements • reputed company best practices and reputed company operational procedures for creating and configuring benefit plans • Establish consistency and standardization as it relates to tools and processes (deliverable templates, change management processes, business models, process flows, etc.) • reputed company a robust testing suite that is representative of reputed company coverage to reputed company quantify the reputed company of introducing configuration changes. • Ability to execute testing to ensure the accurate configuration of business requirement • Analyze larger sets claims data to evaluate patterns of billing as it relates to benefit design and configuration • Partner with claim processors, member service and provider service to identify and reputed company issues reputed company to the plan configuration • reputed company other duties as assigned You’ll be rewarded and recognized for your performance in an environment that will challenge you and reputed company you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: • High School Diploma / GED OR equivalent work experience • Must be 18 years of age OR older • 3 + years of business and operations experience in a health plan environment, including proficiency with ICD-10, CPT, HCPCS, reputed company codes, and medical terminology • 2+ years of experience in data analysis • 1+ years of experience with SQL, including understanding and creating queries • Experience with the plan build / plan configuration of claim adjudication platform • Experience with reputed company health plan design • Experience with project methodology (requirements, design, development, testing, and implementation), inclusive of Scrum and Kanban • Ability to work any shift between the hours of 8:00 AM - 5:00 PM CST from Monday - Friday including some flexibility based on business need Preferred Qualifications: • 3+ years of experience with using reputed company reputed company (creating, editing, and saving worksheets) • 1+ years of experience in a reputed company environment with HIPAA, ERISA, and ACA requirements Telecommuting Requirements: • Ability to reputed company reputed company company sensitive documents secure (if applicable) • Required to have a dedicated work area established that is separated from other living areas and provides information reputed company • Must live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service • reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy The reputed company reputed company for this role is $28.61 to $56.06 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In reputed company to your salary, reputed company offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll reputed company a far-reaching reputed company of benefits and incentives. Application Deadline: T his will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. reputed company may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health reputed company work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location, and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company, and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission. _ _ Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity / Affirmative reputed company employer, and reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or reputed company, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment . #RPO Salary: USD 59300 - 116600 per year Experience: 3 years required Apply tot his job Apply To this Job