Senior Provider Configuration & Claims Optimization Analyst

MetroPlusHealth; New York (NY); On-site; USD 85,000 - 110,000; Full time

Job summary

A healthcare organization is seeking a Senior Provider Configuration Analyst to ensure the proper configuration of their systems for claims processing. This role requires 6+ years of experience in data processing within a healthcare or claims environment and focuses on provider reimbursement configurations, workflow analysis, and system performance management. Ideal candidates will have a Bachelor's degree and experience with HealthEdge HRP and Source products. Additional competencies include attention to detail and the ability to manage multiple priorities.

Qualifications

• 6+ years of experience in configuration for data processing and computer systems.
• Experience in a healthcare or claims environment is essential.
• Demonstrated ability to analyze workflows and support system configuration.

Responsibilities

• Configure provider reimbursement and maintain fee schedules.
• Analyze departmental requirements for developing strategic plans.
• Ensure claims are processed accurately according to Provider contracts.

Skills

System configuration

SQL

Workflow analysis

Technical documentation

Customer focus

Education

Baccalaureate Degree (Computer Science preferred)

Tools

HealthEdge HRP

HealthEdge Source products

Job description

A healthcare organization is seeking a Senior Provider Configuration Analyst to ensure the proper configuration of their systems for claims processing. This role requires 6+ years of experience in data processing within a healthcare or claims environment and focuses on provider reimbursement configurations, workflow analysis, and system performance management. Ideal candidates will have a Bachelor's degree and experience with HealthEdge HRP and Source products. Additional competencies include attention to detail and the ability to manage multiple priorities.