Configuration Analyst

Socket.dev; Naperville (IL); Hybrid; USD 60,000 - 75,000; Full time

Benefits offered by this job

Tuition reimbursement

Volunteer time off

On-site fitness center

Companywide bonus program

Hybrid work schedule

Job summary

Delta Dental of Illinois in Naperville, IL seeks a strategic and analytical Configuration Analyst to optimize claim adjudication logic within our claims administration system. You will become a SME for system configuration tools and collaborate with business units across Accounts, Benefits, Billing, Providers, and EDI processing.

The role emphasizes translating business needs into user stories and test scenarios and monitoring policy adherence.

Qualifications

• Bachelor's degree in business, insurance, or related field (or equivalent work experience).
• Strong knowledge of policy interpretation; familiarity with dental claims terminology and CDT codes.
• Strong analytical and problem-solving skills related to claims processing and/or claims administration system research.
• Experience translating business needs into user stories, acceptance criteria, or requirements.
• Strong technical skills and proficiency in Microsoft Office.
• Experience with SQL, databases, and BI tools is a plus.

Responsibilities

• Analyze and configure claim adjudication logic for claims administration system according to processing policy guidelines.
• Participate in configuration activities supporting Accounts, Benefits, Billing, Providers, Claims, and EDI processing.
• Become a subject matter expert in system configuration tools to support dental policy interpretation and plan building.
• Develop user stories, acceptance criteria, or requirements and test claim scenarios for configuration changes.
• Monitor and analyze the adjudications system’s performance for proper rule application and processing policies.

Skills

Analytical thinking

Problem solving

Interpersonal skills

Technical savvy

Microsoft Office

SQL

BI tools

Education

Bachelor’s degree in business/insurance or related field

2 Year Degree

Tools

SQL

Business Objects

Footprints

Salesforce

Crystal Reports

Database/data flow management

Job description

Job Details: Level: Experienced, Job Location: Delta Dental of Illinois - Naperville, IL, Education Level: 2 Year Degree, Salary Range: $60000.00 - $75000.00Salary/year, Configuration Analyst - We offer a companywide bonus program, tuition reimbursement, volunteer time off, an on-site fitness center and the flexibility of a hybrid work schedule as described in our Workplace Flexibility policy. We are the largest dental insurance company and continue to grow. Based in Naperville, IL Delta Dental of Illinois has over 50 years of oral health experience and is dedicated to clients and employees alike. Our company culture is inclusive, innovative and focused on achieving our goals. We believe in improving oral health through our dental benefit programs and through our Foundation, which develops and supports projects and organizations that improve access to oral healthcare and oral health education. Delta Dental of Illinois is seeking a strategic and analytical Configuration Analyst who can:

Key Responsibilities

• Analyze and configure claim adjudication logic for claims administration system according to processing policy guidelines and assist in the assessment of claim processing issues.
• Participate in configuration activities supporting diverse business needs including but not limited to Accounts, Benefits, Billing, Providers, Claims, Correspondence and EDI processing.
• Become a subject matter expert in using system configuration tools to support business and user needs for dental policy interpretation, plan building, claims administration, processing policies, billing, contracts, correspondence and dental insurance coding.
• Develop user stories, acceptance criteria or requirements and test claim scenarios to determine impact of configuration changes related to claim adjudication changes and/or system enhancements.
• Monitor and analyze the adjudications system’s performance regarding the proper application of rules, and processing policies.

Qualifications

• Bachelor’s degree in business, insurance, or related field (or equivalent work experience gained from role as claims processing leader or Business Systems Analyst supporting an Operations function).
• Strong knowledge of policy interpretation; familiarity with dental claims terminology and CDT codes, and knowledge of claim processing and claim policies and procedures.
• Strong analytical and problem-solving skills related to claim processing and/or claims administration system research.
• Experience interacting with business leaders and an IT (ideally Agile) team to translate business needs into user stories, acceptance criteria, or requirements.
• Strong technical skills/computer savvy.
• High level of proficiency in Microsoft Office (Outlook, Word, Excel) applications required.
• Prior experience in database/data flow management, business analytics, SQL, programming languages or tools such as Business Objects, Footprints, Salesforce and/or Crystal Reports is highly desired.
• Must be well organized and attentive to detail with a proven reputation for thorough research and documentation.
• Strong interpersonal, written and oral communication skills and the ability to interact positively with both technical team members and business users.
• Ability to work independently and be self-motivated and directed in a fast paced, high-pressure environment.

Why Should You Apply?

• Free dental for employees and their dependents
• Competitive benefits: free vision, life, STD/LTD for employees/medical options for many budgets/401k and company match
• Generous PTO program; 11 paid holidays per calendar year
• Great people and culture
• Healthy work/life balance
• Conveniently located off I-88 in Naperville, IL
• Hiring base pay range is $60,000 - $75,000 annually

Delta Dental of Illinois is an equal opportunity employer.