Remote Claims Ops Config & Integration Analyst

centene

United States

Hybrid

USD 37,000 - 67,000

Full time

3 days ago

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Job summary

Centene is seeking an Operations Configuration and Integration Analyst to create, update, test, and maintain system configuration tables and files that support accurate claims adjudication across multiple products and states. You will analyze and load configurable tables, assist in testing scenarios, perform unit-end-user testing, and identify automation opportunities to improve claims processing.

The role requires a Bachelor’s degree and 2–3 years in automated claims environments; Centene

Qualifications

Bachelor's degree or equivalent in managed care environment.
2–3 years in automated medical claims environment and managed care/multi-product environment desired.
1–2 years in systems logic and testing desired.

Responsibilities

Create, update, test and maintain system configuration tables and files for claims adjudication.
Analyze, load, test and maintain configurable tables and files for claim adjudication rules and provider reimbursement.
Develop and execute testing scenarios and test conditions.
Perform unit and/or end user testing for configuration changes, new benefit designs, contracts or software changes.
Identify opportunities to increase automation and improve claims processing to meet business needs.
Research and resolve configuration-related claim problems in a timely manner.
Develop system queries to determine problem scope and propose solutions.