Claims Configuration Analyst

Commonspirit; Camarillo (CA); On-site; USD 100,000 - 125,000; Full time

Job summary

An established industry player is seeking a Configuration Analyst to enhance information products and improve data quality. This role involves consulting on design, testing, and developing solutions for internal and external clients. You will analyze complex data, ensuring accuracy in claims processing and enhancing business processes. The position offers a flexible remote work environment while maintaining standard business hours. Join a forward-thinking organization that values quality care and offers a comprehensive benefits package, including competitive pay and a generous 401k plan.

Benefits

Flexible Health & Welfare benefits

401k retirement plan with employer match

Paid Time Off

Sick Leave

Qualifications

• 3-5 years of experience in Excel and claims understanding.
• Healthcare background with excellent communication skills.

Responsibilities

• Provide consultation on design and enhancement of information products.
• Analyze complex data for trends and root cause analysis.

Skills

Excel

Claims Analysis

Data Quality Oversight

Communication Skills

Data Analysis

Education

Associate's Degree

Tools

QNXT

EZCAP

MS SQL

Job description

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Overview

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

Responsibilities

• This position is remote, but will be expected to work 8AM-5PM PST business hours.
• Position Summary: Provides consultation on the design, testing and enhancement of information product including technical assistance and product development support to external and internal customers.
• Researches, manipulates and prepares complex data to document program activities and reports on its results.
• Provides oversight to data quality and provides feedback to various areas in order to improve auto adjudication rate and claim payment accuracy.
• Develops a consultative relationship with internal/external customers.
• Performs ongoing research, and support tasks for existing systems.
• Leads or acts as a business technical expert in the design of new applications or enhancements including integration of solutions.
• Directs the implementation of program specific information through education, technology, organizational methods and procedures.
• Influences enhancements to business processes and system infrastructure to improve data quality availability and access.
• Analyzes complex data for trends, highlights in-depth interpretations and provides in-depth root cause analysis.
• Translates complex data into constructive data and information and makes recommendations.
• Defines, identifies, develops and implements information products to support strategic business and operational planning.

Qualifications

Minimum Qualifications

• 3 years working experience reading and understanding claims.
• 3-5 years working experience within Excel.
• 3-5 years working experience within QNXT.
• Associate's degree or equivalent experience required.
• Healthcare background.
• Working knowledge of reading and reviewing claim and coding types.
• Excellent verbal and written communication skills.

Preferred Qualifications

• Previous experience with EZCAP preferred.
• MS SQL experience is a plus.

Pay Range

$25.70 - $35.34 /hour

Seniority level

• Not Applicable

Employment type

• Full-time

Job function

• Information Technology

Industries

• Wellness and Fitness Services, Hospitals and Health Care, and Medical Practices