Remote System Configuration Analyst - Claims & UM

LIBERTY DENTAL PLAN CORPORATION; Tustin (CA); Hybrid; USD 65,000 - 75,000; Full time

Benefits offered by this job

401(k) match

Medical insurance

Vision insurance

Dental coverage

Remote or hybrid work

Job summary

LIBERTY Dental Plan Corporation in Tustin, CA, is seeking a System Configuration Analyst to ensure claims and UM systems are accurate, efficient, and aligned with benefit design and regulatory expectations. You’ll partner with Claims, UM, Account Management, Quality Management, Compliance, and IT to configure, test, and maintain system logic supporting high-quality service delivery.

This role emphasizes cross-functional collaboration, detailed testing, and documentation, with a focus on system

Qualifications

• Minimum 2 years of experience in PPO and HMO claims processing, billing, and/or auditing.
• Looking for someone with HSP systems knowledge, dental procedure knowledge, HSP denial explanations, Service restrictions, Basic data analytics experience.
• Proficiency with Microsoft Office tools, including Word, Excel, and Access.
• Strong written and verbal communication and presentation skills.
• Advanced analytical skills, including data-mining, reporting, and analysis.

Responsibilities

• Coordinate, track, and complete claims and UM-related projects
• Analyze and process complex claim and UM scenarios
• Assist with benefit implementation and claims/UM system configuration
• Coordinate with cross-functional teams to implement and maintain member notifications related to claim and UM decisions and outcomes
• Support research projects and new business implementations as needed
• Partner with management to create, update, and maintain departmental policies and procedures
• Audit and test existing system code rules and provide recommendations for improvement
• Audit and test new and existing benefit setups related to claims and UM adjudication
• Support Crystal Report implementation related to claims and UM activities
• Perform other duties as assigned

Skills

Claims processing

Data analytics

Communication

Analytical thinking

Multitasking

Education

High School Diploma or GED

Tools

Microsoft Word

Microsoft Excel

MS Access

Crystal Reports

Job description

LIBERTY Dental Plan Corporation in Tustin, CA, is seeking a System Configuration Analyst to ensure claims and UM systems are accurate, efficient, and aligned with benefit design and regulatory expectations. You’ll partner with Claims, UM, Account Management, Quality Management, Compliance, and IT to configure, test, and maintain system logic supporting high-quality service delivery.

This role emphasizes cross-functional collaboration, detailed testing, and documentation, with a focus on system