What are the responsibilities and job description for the Configuration Analyst - Claims position at Molina Healthcare Group?
Job Description
JOB DESCRIPTION
Job Summary
Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements.
KNOWLEDGE/SKILLS/ABILITIES
- Loads and maintain contract, benefit or reference table information into the claim payment system and other applicable systems.
- Participates in defect resolution for assigned component
- Assists with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality.
- Assists in planning and coordination of application upgrades and releases, including development and execution of some test plans.
- Participates in the implementation and conversion of new and existing health plans.
- Must have experience in system configuration.
- Monitor claims, create , generate and analyze reports using Excel
- Monitor state regulations and make changes if needed.
- Must have experience in claims, advanced excel for analyzing and presenting data.
- Experience working in a Revenue cycle mgmt or Managed care environment is preferred, healthcare experience is required.
JOB QUALIFICATIONS
Required Education
Associate degree or equivalent combination of education and experience
Required Experience
2-5 years
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
5-7 years
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Info
Job Identification: 2030026
Job Category: Operations
Posting Date: 2025-02-17T16:53:38 00:00
Job Schedule: Full time
