System Configuration Analyst
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Job Description
System Configuration Analyst optimizing dental claims and utilization-management systems at LIBERTY Dental Plan. Configuring, testing, and auditing benefit logic, claims rules, and member notifications.
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
Requirements:
- Bachelor’s degree
- Minimum of 2 years of experience in PPO and HMO claims processing, billing, and/or auditing
- 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
- Ability to reason logically, make sound decisions, and communicate effectively under varied circumstances
- Ability to multitask and work efficiently with interruptions or competing priorities
- HSP systems knowledge
- Dental procedure knowledge
- HSP denial explanations knowledge
- Service restrictions knowledge
- Basic data analytics experience
- Prior auditing experience preferred
- Must work in the United States
- No sponsorship available at this time
Benefits:
- Competitive pay structure and savings options
- 401(k) retirement benefits, including employer match, Roth IRA options, immediate vesting during the Safe Harbor period, and access to professional financial advice through Financial Engines
- Affordable medical insurance, with low-cost premiums for employee-only coverage
- 100% employer-paid dental coverage for employees and eligible dependents
- Vision insurance with low-cost premiums for employee-only coverage and dependents
- Company-paid basic life and AD&D insurance equal to one times base salary, with options to purchase additional supplemental coverage
- Flexible Spending Accounts for healthcare and dependent care expenses
- Voluntary benefit programs, including accident, critical illness, and hospital indemnity insurance
- Long-term disability coverage
- Expansive wellness programs, including company-wide wellness challenges, BurnAlong memberships, and gym discounts
- Employee Assistance Program (EAP) to support mental health and well-being
- Generous vacation and sick leave policies, with ability to roll over unused time
- 10 paid company holidays
- Tuition reimbursement for eligible educational expenses
- Remote or hybrid work options available for various positions
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