Position Overview
The Benefit Configuration Analyst will be responsible for constructing the Claims Processing Systems to process new enrollments. Experienced candidates must demonstrate working understanding of claims processing systems and
working knowledge of the health care industry.
Scope of Role & Responsibilities
- Configure MHP’s core systems to meet regulatory requirements and business needs.
- Meet with business areas to gather configuration requirements.
- Create and maintain Core Systems user guide related to configuration changes.
- Create and maintain Core Systems user guide related to configuration changes.
- Test system modifications and configuration changes.
- Analyze business process to improve efficiencies.
- Create templates on benefits to track current configuration.
- Ensure system processes and services are aligned with the department’s need.
- Analyze the system to ensure claims are processed correctly to prevent the company from liabilities.
- Collaborate with MetroPlusHealth system consultants to correct errors, rectify omissions, and investigate questionable issues.
- Identify potential system problems for claims resolution.
- Analyze business processes, gather the requirements, and document the requirements in line with the strategic initiative
- Review test cases making sure they are in accordance with requirements and assist the overall testing process.
- Conduct ongoing reviews of systems and processes to ensure accurate and optimum setup for claims.
- Attend meetings with managers regarding process plans, functionality, and business processes.
- Receive, coordinate, and manage requests for Systems Modifications
- Maintain and track open issues and coordinate releasing testing
- Document policies and procedures
- Ability to run reports utilizing sequel
- Monitor and Manage Core Systems performance
- Respond to escalated issues from various MetroPlusHealth Departments.
- Perform and assist with any other functions as required by the Director of Core Systems Operations
- Participate in special projects as needed.
Required Education, Training & Professional Experience
- A Baccalaureate Degree from an accredited college or university; and
- Five (5) years of progressive, responsible experience in configuration for data processing, computer systems and applications; or
- A satisfactory equivalent combination of training, education and experience.
Professional Competencies
- Integrity and Trust
- Customer Focus
- Functional/Technical skills
- Written/Oral Communication
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