Job Attributes

Work Schedule/Shift

Not Available

Job ID

5000383502106

Req. No

70028258

Job Title

Configuration Support Analyst

Region

CHRISTUS System Office

Category

Healthcare

Division

Not Defined

Company

CHRISTUS Health

Travel

1-10%

Facility

Corp USFHP-55100

Address

919 Hidden Ridge
Irving, TX  75038
US

Type

Full Time

Apply Now Configuration Support Analyst Job in Irving

POSITION SUMMARY

Under the supervision of the Configuration Support Supervisor, the Configuration Support Analyst is responsible for identifying system issues and providing defect resolution analysis via claims and system analysis in support of the Benefits Configuration and Provider Data departments. The analyst collaborates closely with peers and management to ensure that the most complex data sets are analyzed and the research is reported to all affected areas for fast resolution.

MAJOR RESPONSIBILITIES
  • Identify and communicate data quality issues through extensive research by comparing system information to applicable claims based on benefit structure, contract details, and pricing methodologies.
  • Takes initiative in leading projects and collaborating with others.
  • Autonomously researches and implements solutions to detect and correct problems, designs code to recycle errors, and develops alarm reports and monitoring programs.
  • Analyzes system data to determine root cause of data quality issues directly affecting claims payment and/or denials.
  • Initiates claims payment analysis based on internal requests from the Health Plan by partnering with IT department for applicable reports to determine underpayments and overpayments to providers.
  • Catalog internal defect results and recommendations then communicating all findings to affected areas and appropriate leadership
  • Collaborate and maintain open communication with all departments within CHRISTUS Health to ensure effective and efficient workflow to facilitate completion of tasks/goals
  • Assist with developing and maintaining departmental goals and objectives as well as personal goal maintenance on a quarterly basis.
  • Assist in the development of action plans to address system deficiencies
  • Monitor and track best practices while also reviewing compliance changes/impacts for continuous improvement opportunities
  • Identify prevalent trends through data reporting and claims analysis
  • Assists in disseminating information to staff as needed
  • Performs other related duties and special projects as requested
  • Follow the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI)

POSITION QUALIFICATIONS
A. Education/Skills:
  • Bachelor's degree or equivalent experience in Healthcare claims adjudication, system configuration, and auditing
  • Ability to organize and prioritize work to meet deadlines
  • Strong computer application skills including Microsoft Word, Excel, Visio, SQL
  • X12 experience desired
  • Excellent written and verbal communication skills required
  • Good judgment, initiative and problem solving abilities
  • Ability to handle and resolve complex issues independently
  • Knowledge of Medicaid, Medicare Advantage, Tricare and Health Care Exchange programs preferred
  • Knowledge of CPT/HCPCS, ICD-9, ICD-10 coding and medical terminology
  • Ability to learn new policies and processes based on written material and observation
  • Ability to establish and maintain professional, positive and effective work relationships
B. Experience
  • Healthcare experience with Managed Care experience preferred
  • System configuration experience preferred
  • 2 years' experience with claims resolution and/or configuration audit
  • Prior experience working with TRICARE, Texas Medicaid, Medicare Advantage and Health Care Exchange programs highly desirable.
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