What are the responsibilities and job description for the Provider Configuration Analyst position at MetroPlusHealth?
Position Overview
The Provider Configuration Analyst will be responsible for the configuration of MetroPlus Health ’s systems to ensure that claims are processed according to Provider contracts.
Job Description
- Configure provider reimbursement and create and maintain fee schedules
- Apply technical and business knowledge to analyze departmental requirements needed to develop long and short-term plans.
- Ensure system processes and services are aligned with the department’s need.
- Analyze the system to ensure claims are processed correctly to prevent the company from liabilities.
- Collaborate with MetroPlusHealth’s system consultants to correct errors, rectify omissions, and investigate questionable issues.
- Identify potential system problems for claims resolution.
- Analyze business processes, gather the requirements, and document the requirements in line with the strategic initiative
- Review test cases making sure they are in accordance with requirements and assist the overall testing process.
- Conduct ongoing reviews of systems and processes to ensure accurate and optimum setup for both provider and claims.
- Attend meetings with managers regarding process plans, functionality, and business processes
- Receive, coordinate, and manage requests for Systems Modifications
- Maintain and track open issues and coordinate releasing testing
- Document policies and procedures
- Ability to run reports utilizing sequel
- Create and maintain an inventory of pricing templates and their contents
- Monitor and manage Core Systems performance
- Respond to escalated issues from various MetroPlusHealth Departments.
- Perform and assist with any other functions as required by the Director of Core Systems Operations
- Participate in special projects as needed
Minimum Qualifications
Professional Competencies
MHP50
Salary : $105,000 - $115,000
