Configuration Analyst (Health Rules)

AppLab Systems, Inc; Jefferson City (MO); On-site; USD 62,000 - 103,000; Full time

Job summary

AppLab Systems, Inc seeks a Configuration Analyst - Health Rules in Jefferson City, MO on a contract basis. You will design, configure and test HealthRules Payor configurations for contracts, products and policies to implement HealthRules Payor.

You will analyze, test, train on releases, develop test scenarios, maintain configuration docs, collaborate with business users and QA, and drive timely updates for Medicare business.

Qualifications

• Minimum 3 years of payer operations and claim processing experience.
• 3 years of hands-on configuration experience in HealthRules Payor.
• Working knowledge of Medicare operations, system development and testing.
• Proficient with Microsoft Office applications including Excel, Word, Access, PowerPoint and Visio.
• Experience in a matrix organization with strong communication skills.

Responsibilities

• Design, configure and test HealthRules Payor configurations for contracts, products and policies.
• Analyze, configure, test and maintain HealthRules Payor to support contracts, products and policies.
• Test, implement and train on HealthRules Payor releases and third-party modules.
• Develop test scenarios and manage bug resolution; generate postproduction audit reports.
• Create and maintain configuration documentation; communicate changes.
• Collaborate with business users, tech teams and QA on requirements and testing.
• Respond to service requests and update configurations in HealthRules Payor as needed.
• Recommend procedures to maximize HealthRules Payor efficiency and usage.
• Inform leadership of Medicare-related changes and implement timely updates.

Skills

HealthRules Payor

Payer Operations

Medicare Operations

MS Office Suite

Communication Skills

Education

Bachelor's degree

Tools

ClaimXten

Axiom TranSend

Axiom TransShuttle

Job description

Role: Configuration Analyst - Health Rules

Location: Jefferson City, MO

Type: Contract

RESPONSIBILITIES:

• Design, Develop, Configure and Test HealthRules Payor configuration, contracts, products, and policies to Implement HealthRules Payor.
• Analyze, configure, test, implement and maintain HealthRules Payor to support changes in contracts, products, legislation, policies, and procedures, ensuring timely maintenance and updates of configuration.
• Test, implement and train on new HealthRules Payor and third party product releases, modules and updates.
• Assist in the development of test scenarios for changes and/or projects. Manage the timely resolution of open testing bugs and issues. Develop and monitor postproduction audit reports to ensure the intent of change and/or project requirements is being met.
• Develop and maintain configuration documentation and communicate changes, as appropriate.
• Work with Business Users, Technical team and QA to create detailed functional requirements that support and align to business requirements and testing scenarios.
• Research and respond to service requests in a prompt and timely manner and update or build configuration in HealthRules Payor as needed.
• Recommend and draft new and updated procedures to maximize the use of HealthRules Payor and other third-party products to improve efficiency.
• Inform leader and peers of changes that will impact Company’s Medicare business. Research and recommend methods to improve or implement necessary changes in a prompt and efficient manner.

EXPERIENCE/SKILLS:

MINIMUM REQUIREMENTS:

• Minimum of 3 years of experience in payer operations, claim processing, and experience deploying HealthRules Payor software.
• Minimum of 3 years of hands-on configuration experience in HealthEdge's HealthRules software.
• Must possess working knowledge of Medicare operations, system development and testing.
• Expertise in using Microsoft Office; including Excel, Word, Access, Power Point, and Visio.
• Experience working within a matrix organization. Excellent oral and written communication skills and the ability to interface with all levels of customer organization.

PREFERRED REQUIREMENT:

• Previous experience with CMS and Medicare Operations.
• Knowledge of or experience with ClaimXten, Axiom TranSend, and Axiom TransShuttle.

EDUCATION

• Bachelor’s degree in business or health care preferred; demonstrated work experience may be considered in lieu of degree.

SKILLS

• Collaboration, leadership, organizational, writing, interpersonal and communication skills.