Healthcare IT Configuration Analyst

Independent Living Systems; Miami (FL); On-site; USD 65,000 - 90,000; Full time

Job summary

Independent Living Systems (ILS) is seeking a Configuration Analyst to ensure healthcare software configurations meet regulatory and operational needs. You will analyze system configurations, implement changes, and document testing to support reliable member care workflows.

Collaborating with clinical, administrative, and IT teams, you will tailor configurations for compliance and data integrity, contributing to high-quality healthcare services and efficient clinical processes.

Qualifications

• High School diploma or GED required.
• Minimum two (2) years' experience as a medical Senior Claim Examiner, Call Center Advocate, Business Analyst or Trainer.
• Knowledge of UB04 / CMS1500 claims, ICD-10 / Revenue / CPT / HCPCS diagnosis and procedure coding, claim adjudication processes, EDI and OCR claim submission, Medicare and Medicaid reimbursement methodologies including APR DRG / Exempt Units / APG / RBRVS / APC.
• Proven ability to analyze data and summarize in an organized and professional manner effectively and efficiently.
• Ability to read and interpret contracts and other related documents required.
• Function in a fast-paced environment that requires prioritizing workloads and multi-tasking to complete projects on time.
• Excellent verbal, written and presentation skills required.
• Proficient in Microsoft Office (Word, Excel, PowerPoint, and Access) required.
• Relevant education may substitute for educational requirement on a year-for-year basis.

Responsibilities

• Claims testing and processing including claim adjustments, as well as providing support and education to the staff as necessary.
• The incumbent will troubleshoot and resolve provider records to support the claims operation.
• Process claims in accordance with corporate policies and procedures and state regulations.
• Review and analyze a variety of claim samples including auto-adjudicated claims to assure pricing per contractual agreement, negotiated rate or to Medicaid and Medicare rates.
• Provide consistent feedback to Management in timely manner both individually and collectively.
• Participate in ad-hoc projects as necessary.

Skills

Analytical thinking

Verbal communication

Written communication

Presentation skills

Multi-tasking

Contract interpretation

Education

High School diploma

Associate's degree in health care

CPHIMS certification

Tools

Microsoft Office

Excel

Data analytics tools

Job description

Independent Living Systems (ILS) is seeking a Configuration Analyst to ensure healthcare software configurations meet regulatory and operational needs. You will analyze system configurations, implement changes, and document testing to support reliable member care workflows.

Collaborating with clinical, administrative, and IT teams, you will tailor configurations for compliance and data integrity, contributing to high-quality healthcare services and efficient clinical processes.