Claims Systems Configuration Associate Analyst
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Job Description
Claims Systems Configuration Associate managing configuration and execution of healthcare claims. Ensuring data integrity and optimizing claims processing within eviCore's adjudication systems.
Responsibilities:
- Configuration Associate will complete tasks with guidance (as needed) from mentor and/or Claims Configuration Supervisor
- Work from the Enterprise Jira platform utilizing project methodologies to maintain and upkeep tickets for claim system configuration requests
- Claims system configuration requests will include but are not limited to proprietary claim edits, industry standard claim edits, and benefit rules for all claim products and programs
- You'll review, coordinate, and outline claims system configuration changes to meet needed requirements
- Document configuration changes in Microsoft Excel checklist to confirm changes
- Test configuration changes to validate claims are processing based on requirements
- Utilize SQL queries to review configuration and claims data
- Make updates to configuration via Access database
- Run post-production review on claims to validate changes deployed to production are processing as expected
- Investigate claim processing to determine claim configuration root cause analysis
Requirements:
- High school diploma or GED required; associate degree in a computer-related field preferred
- Minimum of two (2) years of experience working with claims or healthcare data required
- One (1) year of experience of configuring medical claims systems required
- Demonstrated ability to write and run basic queries using Microsoft SQL Server, required
- At least one (1) year of experience working with Microsoft Access database, including data manipulation, required
- Proficiency in Microsoft Excel, including the use of pivot tables, formulas, and charts, preferred
- Strong technical aptitude with demonstrated critical thinking abilities and excellent communication skills
Benefits:
- medical
- vision
- dental
- well-being and behavioral health programs
- 401(k)
- company paid life insurance
- tuition reimbursement
- a minimum of 18 days of paid time off per year
- paid holidays
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