Configuration Specialist - Central Ave

Terros Health; Phoenix (AZ); On-site; USD 50,000 - 70,000; Full time

Benefits offered by this job

Multiple medical plans

Multiple dental plans

401(k) with company match

4 Weeks of paid time off

Wellness program

Pet Insurance

Employee Assistance Program

Professional growth & development

Tuition discounts

Gym memberships

Job summary

A healthcare organization in Phoenix is seeking a detail-oriented professional to assist in configuring its practice management system. Responsibilities include ensuring appropriate billing and claims processing, maintaining payer contracts and policies, and preparing performance reports. Ideal candidates should have a commitment to outstanding customer service and effective relationship-building. Opportunities for professional growth are also offered, alongside various employee benefits.

Responsibilities

• Assist in configuring the practice management system for billing and claims processing.
• Develop and maintain understanding of payer and NextGen configuration rules.
• Assist in maintaining system flags and their impact on claims.
• Accountable for customer service to internal and external customers.
• Assist in preparing reports on claims accuracy and performance.

Job description

Overview

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.

Responsibilities

• 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.
• Develop and maintain an understanding of current payer and NextGen configuration rules, contracts, and policies.
• Assist 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.
• Assist in the development and execution of test scenarios for configuration changes.
• Assist in the maintenance of system flags and understand 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.
• Meet department production and quality standards.
• Assist 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.
• Develop and maintain 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 escalate issues and to whom to ensure the highest quality resolution.

Benefits

• Multiple medical plans - including a no premium plan for employees and their families
• Multiple dental plans - including orthodontia
• Financial well-being - 401(k) with a company match, interest free medical line of credit, financial education, planning, and support
• 4 Weeks of paid time off in the first year
• Wellness program
• Pet Insurance
• Group life and disability insurance
• Employee Assistance Program for the Whole Family
• Personal and family mental and physical health access
• Professional growth & development - including scholarships, clinical supervision, and CEUs
• Tuition discounts with GCU and The University of Phoenix
• Working Advantage - Employee perks and discounts
• Gym memberships
• Car rentals
• Flights, hotels, movies and more
• Bilingual pay differential