What are the responsibilities and job description for the Team Lead, Configuration Testing - R8424 position at CareSource?
Job Summary
The Team Lead, Configuration Testing is responsible for day-to-day activities surrounding the knowledge and insight around testing of medical benefits, provider reimbursement, letters, claims workflow and clinical editing.
Essential Functions
$81,400.00 - $130,200.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type
Salary
Competencies
The Team Lead, Configuration Testing is responsible for day-to-day activities surrounding the knowledge and insight around testing of medical benefits, provider reimbursement, letters, claims workflow and clinical editing.
Essential Functions
- Responsible for day-to-day activities surrounding the knowledge and insight around testing of medical benefits, provider reimbursement, letters, claims workflow and clinical editing
- Guide and direct successful completion of daily tasks. Responsible for onboarding, training and development of staff
- Prioritize all work, requests and activities. Escalate any area of significant resource contention along with recommendation for resolution
- Track issues and status to ensure proper follow-up, coordination with business area and provide solutions
- Update project that configuration is involved with and coordinate any needed changes with manager
- Provide management with ticket dashboards. Identify root cause of issues and appropriate pro-active resolution to reduce tickets in the future
- Ensure ticket controls, communication and approvals are followed prior to system implementation
- Maintain and support fee schedules and methodology is consistent with required standards
- Provide oversight to vendor management tasks conducted by team members. Ensure timely responses and resolution
- Assist in auditing system configuration to ensure accuracy and internal controls are in place to minimize potential fraud and abuse and any business issues
- Perform any other job duties as requested
- Associates Degree or equivalent years of relevant work experience is required
- Minimum of three (3) years of health plan business or systems solutions experience is required
- Exposure to Facets or equivalent system is preferred
- Prior supervisory experience is preferred
- Advanced computer skills and abilities in Facets or similar processing systems
- Medical terminology
- Advanced proficiency in Microsoft Suite to include Word, Excel and Access
- High level of programming and systems development knowledge
- Effective identification of business problems, assessment of proposed solutions to those problems, and understanding of the needs of business partners
- Demonstrated ability to successfully define a portfolio of initiatives including business requirements gathering, definition/prioritization, project scope definition, project staffing requirements, application configuration, testing approach, training, documentation, reporting strategy, and change management process
- Knowledge of regulatory reporting and compliance requirements
- Excellent listening and critical thinking skills
- Effective problem solving skills with attention to detail
- Excellent written and verbal communication skills
- Ability to work independently and within a team environment
- Strong interpersonal skills and high level of professionalism
- Ability to develop, prioritize and accomplish goals
- Proper medical coding knowledge and claims processing skills
- Certified Professional Coder (CPC) is preferred
- General office environment; may be required to sit or stand for extended periods of time
$81,400.00 - $130,200.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type
Salary
Competencies
- Create an Inclusive Environment - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business
Salary : $81,400 - $130,200