What are the responsibilities and job description for the Contract Configuration Analyst position at Advanced Medical Management?
Job Description
Job Description
POSITION SUMMARY
The Configuration Analyst will be responsible for supporting all aspects of system configuration ensuring that all system configurations are programmed accurately for Authorizations and Claims.
RESPONSIBILITIES-DUTIES
Configure rates based on provider contracts to ensure accurate payments of claims and capitations to providers.
Configure rates based on vendor contracts to ensure accurate payments.
Maintain system configuration based on data received from contracting
Audit accuracy of Fee schedules in test environment prior to in-loading in production
Assign Fee Set Assignments by line of business or health plan code
Program and audit Interest Payment
Program and audit RBRVS Geographical Adjustment
Apply previous experience and knowledge to research and resolve claim / encounter issues, pended claims and update system as necessary
Coordinating with internal departments to resolve and assist with system related issues / builds
Other duties may be assigned by the Supervisor of Contract Configuration or Manager of Contract Configuration.
Ability to handle fluctuating volumes of work and be able to prioritize work to meet deadlines and needs of user community.
EDUCATION & EXPERIENCE REQUIREMENTS
Minimum 5 years’ of administrative healthcare experience preferred
High School Diploma or GED, some college preferred
Experience with benefits and system configuration and interpretation
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