Claims Adjudication Systems Config & Integration Analyst

Fidelis Care - New York; New York (NY); Hybrid; USD 3,722,000 - 6,688,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work arrangements

Job summary

Centene is seeking an Operations Configuration and Integration Analyst to support accurate claims adjudication across multiple products and states. You will analyze and maintain system configuration tables, run tests, and collaborate with IS teams to implement changes.

The role requires experience in automated medical claims, systems logic and testing, and a bachelor’s degree in a managed care environment. Flexible schedules including remote, hybrid, field or office work are offered.

Qualifications

• Bachelor’s degree or equivalent in a managed care environment.
• 2–3 years in automated medical claims environment.
• 1–2 years experience in systems logic and testing.

Responsibilities

• Analyzes, interprets, loads, tests and maintains configurable tables and files used for claim adjudication.
• Assists in development and execution of testing scenarios and conditions.
• Performs unit and end-user testing for changes affecting claims rules.
• Identifies system deficiencies and recommends automation improvements.

Skills

Data analysis

SQL queries

Testing

Claims systems

System configuration

Education

Bachelor's degree in healthcare/ managed care

Tools

Macess imaging

MC400 editing

Claims processing software

Job description

Centene is seeking an Operations Configuration and Integration Analyst to support accurate claims adjudication across multiple products and states. You will analyze and maintain system configuration tables, run tests, and collaborate with IS teams to implement changes.

The role requires experience in automated medical claims, systems logic and testing, and a bachelor’s degree in a managed care environment. Flexible schedules including remote, hybrid, field or office work are offered.