Analyst, Configuration Information Management- Healthplan Ops (Remote in GA)

Molina Healthcare; Everett (WA); Remote; USD 77,000 - 129,000; Full time

Job summary

A healthcare organization is looking for a candidate to manage critical information on claims databases and synchronize data. The role involves data analysis, interpreting benefits, and maintaining benefit plans. Experience with GA Medicaid is highly preferred. This position requires an associate degree and offers a competitive salary range between $77,969 and $128,519 annually.

Benefits

Competitive benefits and compensation package

Qualifications

• 2-5 years of experience needed.
• GA Medicaid coding experience preferred.

Responsibilities

• Analyze and interpret data for configuration changes.
• Maintain benefit plans and provider contracts.
• Research and resolve claims issues.

Skills

Data analysis

Configuration management

GA Medicaid claims experience

Education

Associate degree or equivalent

Bachelor's Degree or equivalent

Job description

Overview

Candidates must reside in Georgia. This role is responsible for accurate and timely implementation and maintenance of critical information on claims databases, synchronizing data among operational and claims systems, applying business rules as they pertain to each database, and validating data to meet customer requirements related to contracting, benefits, prior authorizations, fee schedules, and other business requirements.

Responsibilities

• Analyze and interpret data to determine appropriate configuration changes.
• Accurately interpret state and/or federal benefits, contracts, and additional business requirements, and convert these terms to configuration parameters.
• Handle coding, updating, and maintaining benefit plans, provider contracts, fee schedules, and various system tables through the user interface.
• Apply experience to research and resolve claim/encounter issues, pended claims, and update systems as necessary.
• Work with fluctuating volumes of work and prioritize to meet deadlines and the needs of the user community.
• GA Medicaid claims/reimbursement/coding experience is highly preferred.

Job Qualifications

Required Education

Associate degree or equivalent combination of education and experience

Required Experience

2-5 years

Preferred Education

Bachelor\'s Degree or equivalent combination of education and experience

Preferred Experience

5-7 years

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $77,969 - $128,519 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.