Configuration Systems Analyst III - CES
Core
Manage and define system configuration requirements, develop reimbursement design templates, and implement software releases for health plan systems.
Role type
Senior IC configuration systems analyst (health plan)
Builds
Standard code sets, reimbursement design templates, and system enhancements for CareSource's payment policy and core business systems.
Domain
Healthcare / Health Insurance / Reimbursement Systems
Required skills
Facets system expertise, database relationships, DRG/APC reimbursement methods, CPT/HCPCS/ICD-CM coding, HIPAA transaction codes, Medicaid/Medicare knowledge, claims processing
Preferred skills
Certified Medical Coder (CPC), Microsoft Suite (Word, Excel, Access, Visio), vendor relationship management
Technologies
Facets, Microsoft Office Suite
Responsibilities
Manage and define system configuration requirements; develop and utilize reports to analyze data gaps; identify and manage open issues within change management systems; plan and implement new software releases including testing and training; audit configuration to ensure accuracy and minimize fraud/overpayment; coordinate annual benefit changes; mentor team members on tool usage.
Seniority
Senior, hands-on IC