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The Senior Configuration Analyst is responsible for accurate and timely development of automated rules and pricing. This position will also need to help develop new business plans that will help promote technology and automation.
Builds rules within the Peradigm System, in coordination within State and Federal guidelines
Monitors and tests the accuracy of price rules, fee schedules, contract loads as assigned
Researches both State and Federal mandates and builds interpretation grids
Builds and tests contracts and pricing templates for the non-par and new business teams
Trains/monitors staff on contract pricing and contract templates
Ensures proper supporting documentation and maintains files for all price rules
Maintains all automated reports for assigned areas.
Builds and maintains positive business relationships with business partners
Loads contracts/fee schedules into the Peradigm System through appropriate research and provider data load activities
Monitor and develop automated provider loads into the Peradigm
Monitor and develop automated batch claims processing.
Works with management to identify, develop, and implement tools, applications, and reports focused on increased automation, improved load quality, and input/ throughput/output measurement.
Additional Responsibilities:Candidate Education:
Required A High School or GED
Preferred A Bachelor's Degree in a related field
Required 4 years of experience in analytics or related field
Intermediate Other Knowledge of Claims Processing
Advanced Other Understanding of contract terms and how they are loaded into the system
Advanced Other Knowledge of provider/institutional billing practices
Advanced Other Knowledge of report automation
Intermediate Other Ability to effectively research issues and resolve problems
Intermediate Other Process orientation; understanding of process design and flow and associated analytical tools and techniques
Licenses and Certifications: A license in one of the following is required: Technical Skills:
Required Intermediate Xcelys
Required Intermediate SQL Server System SAS, SQL
Required Intermediate Statistical Analysis Systems (SAS)
Required Intermediate Microsoft Excel
Required Intermediate Microsoft PowerPoint
Required Intermediate Other Knowledge of CPT/HCPCS coding
Preferred Intermediate Other Knowledge of database driven programs