Claims Configuration Analyst

Dignity Health; Camarillo (CA); Remote; USD 100,000 - 125,000; Full time

Job summary

An established industry player is seeking a Configuration Analyst to enhance healthcare management services. This role involves analyzing complex data, supporting system improvements, and providing consultation on information products. The ideal candidate will have a strong background in claims analysis and excel in communication. With a focus on patient care and quality service, this position offers an exciting opportunity to impact healthcare delivery positively. Join a team dedicated to innovative solutions in a flexible work environment that values your contributions.

Benefits

Flexible Health & Welfare benefits

401k plan with employer match

Paid Time Off

Sick Leave

Medical, Dental, Vision Insurance

Qualifications

• 3 years of experience reading and understanding claims.
• 3-5 years of experience with Excel and QNXT.

Responsibilities

• Provide consultation on design and enhancement of information products.
• Analyze complex data for trends and conduct root cause analysis.
• Implement program-specific information via education and technology.

Skills

Claims Analysis

Excel

QNXT

Data Analysis

Communication Skills

Education

Associate's Degree

Tools

EZCAP

MS SQL

Job description

Join to apply for the Configuration Analyst role at Dignity Health.

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 leverage economies of scale across provider types and geographies, and lead 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, aiming to coordinate patient care effectively while containing costs and improving quality of care and service levels. We utilize industry-leading technology and integrated administrative systems supported by local human resources that prioritize patient care.

We offer an outstanding Total Rewards package, including competitive pay and a flexible Health & Welfare benefits plan. Employees can choose benefits from options such as medical, dental, vision, HSA, Life Insurance, and Long Term Disability. We also provide a 401k plan with a generous employer match, Paid Time Off, and Sick Leave.

Responsibilities

• This position is remote but requires working 8AM-5PM PST.
• Provide consultation on design, testing, and enhancement of information products, including technical assistance and product development support to internal and external customers.
• Research, manipulate, and prepare complex data, report on activities, and analyze results.
• Oversee data quality, provide feedback to improve auto adjudication rates and claim payment accuracy.
• Develop consultative relationships with customers.
• Support existing systems through research and ongoing tasks.
• Lead or act as a technical expert in designing new applications or enhancements, including system integration.
• Implement program-specific information via education, technology, and organizational methods.
• Influence business process and system infrastructure improvements to enhance data quality and access.
• Analyze complex data for trends, interpret findings, and conduct root cause analysis.
• Translate complex data into actionable insights and recommendations.
• Define, develop, and implement information products to support strategic planning.

Qualifications

Minimum Qualifications:

• 3 years of experience reading and understanding claims.
• 3-5 years of experience with Excel.
• 3-5 years of experience with QNXT.
• Associate's degree or equivalent experience.
• Healthcare background.
• Knowledge of claim reading and coding types.
• Excellent communication skills.

Preferred Qualifications:

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

Pay Range: $25.70 - $35.34/hour