Configuration Specialist

Terros Health; Phoenix (AZ); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

No-premium medical plan

Dental coverage

Vision insurance

401(k) with company match

Paid time off

Job summary

Terros Health is seeking a Configuration Specialist to assist in configuring the NextGen practice management system within payer, contract, and regulatory contexts to ensure accurate billing, posting, and reporting of claims processing activities. This role reports to the Director of Revenue Cycle Management.

You will develop and maintain configuration rules, load contracts, fee schedules, providers, and code mappings, and support testing, audits, and reporting to optimize revenue cycle

Qualifications

• Familiarity with NextGen configuration processes.
• Understanding of payer contracts and fee schedules.
• Strong communication and documentation skills.
• Experience in healthcare revenue cycle management is a plus.

Responsibilities

• Assist in loading payor contracts, providers, and fee schedules.
• Develop and maintain configuration documentation and best practices.
• Prepare reports on claims payable accuracy and timeliness.
• Support testing and post-production audits of NextGen configurations.
• Collaborate with the Director of Revenue Cycle Management and external vendors.

Job description

Terros Health is a healthcare organization of caring people, guided by our core values of integrity, compassion and empowerment, with diversity woven throughout. We engage people in whole person health through an integrated care delivery system, thus establishing a medical home for our patients. In caring for the whole person, we focus on overall wellness through physical health, mental health and substance use care. Our mission is to provide extraordinary care by empowered people through exceptional outcomes.

This position assists the Director, RCM and other Configuration Specialists in correctly configuring the company practice management system (NextGen) in context of medical policies, reimbursement policies, clinical editing policies, regulatory requirements and contract details to ensure appropriate billing, payment/encounter posting, and reporting of all claims processing activities. This position reports to the Director of Revenue Cycle Management.

HOPE ~ HEALTH ~ HEALING

Develop and maintain an understanding of current payer and NextGen configuration rules, contracts, and policies.

Assists in the accurate and timely loading of the following (including annual updates):

• Payor contracts
• Providers
• Fee schedules
• Code set mapping.
• Specialized rules and alerts in Nextgen EPM
• Develop and maintain configuration documentation and communicate configuration processes, changes and best practices.
• Assists in the development and execution of test scenarios for configuration changes
• Assists in the maintenance of system flags and understands the impact of the system flags on the claims and EHR system.
• Develop and monitor post-production audit reports to ensure the intent of NexGen EPM configuration related change and/or project requirements are met
• Run and analyze ad-hoc reports
• Meets department production and quality standards.
• Assists in preparing and delivering reports and recommendations on claims payable accuracy and timeliness and related configuration opportunities to enhance revenue cycle department performance.
• Assist in the implementation of high-level quality and performance management initiatives.
• Accountable for outstanding customer service to all external and internal customers.
• Develops and maintains effective relationships through effective and timely communication.
• Take initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner.
• Documentation of approved software changes, updates, patches and notification of software releases including the tracking of action items and capturing software changes.
• Maintain all applicable configuration baseline documentation
• Participates in code reviews, fixes any defects, and performance problems discovered in testing; and participates in transitions of the application components to the testers.
• Coordinates and assists the Director of Revenue Cycle Management in outside vendor audit compilation and tracking.
• Use sound judgment to determine when to escal...

Benefits & Wellness

We invest in the health, well-being, and success of our employees and their families by offering comprehensive benefits, wellness resources, and opportunities to grow both personally and professionally

• Multiple medical plan options, including a no-premium plan for employees and their families
• Multiple dental plan options, including orthodontic coverage
• Vision insurance
• Group life and disability insurance
• Pet insurance
• 401(k) plan with company match
• Interest-free medical line of credit
• Financial education, planning, and support resources
• Monetary company contribution toward eligible benefits
• Bilingual pay differential
• Generous Paid Time Off (PTO) – 3 weeks off in the first year
• Paid Sick Time
• 10 paid holidays annually
• Comprehensive wellness program featuring wellness challenges, activities, and prizes
• Employee Assistance Program (EAP) available to employees and their family members
• Trip Reduction Program

• Ongoing professional growth and career development opportunities, including:
• Scholarships
• Clinical supervision
• Continuing Education Units (CEUs)
• Tuition discounts through Grand Canyon University, University of Phoenix, and Northern Arizona University (NAU)

• Access to the Working Advantage® Employee Discount Program, with savings on:
• Gym memberships
• Car rentals
• Flights, hotels, movie tickets, and more