Claims Management - Configuration Analyst
Our goals are to provide excellent service, utilize advanced technology, and proficiently deliver results. To accomplish these goals, we constantly seek individuals who look for ways to do things better. We are a company whose
cultivates teamwork, rewards excellence, focuses on quality for every aspect of our business, and promotes community involvement.
Tabula Rasa HealthCare (TRHC) is a leader in providing patient-specific, data-driven technology and solutions that enable healthcare organizations to optimize performance to improve patient outcomes, reduce hospitalizations, lower healthcare costs, and manage risk. Medication risk management is TRHC’s lead offering, and its cloud-based software applications, including EireneRx® and MedWise™, provide solutions for a range of payers, providers and other healthcare organizations.
TRHC empowers our employees to provide excellent service, utilize advanced technology, and proficiently deliver results. Our 32Fundamentals are what we are and who we are. Our culture cultivates teamwork, rewards excellence, focuses on quality for every aspect of our business, and promotes community involvement. As a part of our team, you will help us bring innovative service models to healthcare, improving patient outcomes.
Peak TPA (Peak), a Tabula Rasa HealthCare company, helps PACE organizations manage the business functions that drive the major sources of reimbursement revenue and utilization costs. Peak provides services that optimize financial management and fulfill regulatory requirements for health plan functions. Peak is committed to the PACE model of care and thus to the success of the sponsoring organizations.
Job Description: Configuration Analyst
Summary: Under the supervision of the Assistant Director of Configuration and Provider Network Services, this position is responsible for the configuration of the claims adjudication system.
Performs system configuration analysis, testing, validation, quality review, documentation and maintenance of applications
Works directly with business units and other stakeholders to gather business requirements
Extensively tests fee schedule changes from software vendor
Supports and maintains application designs to meet client needs
Uses basic analytical and problem-solving skills, and an understanding of the business and systems, to resolve problems with production applications
Work with end users to identify needs and resolve problems.
Participates in review, impact assessment, testing and modifications for application updates, upgrades and installations
Assists with special projects, as requested
Communicates clearly and concisely, with sensitivity to the needs of others
Maintains the confidentiality of all company procedures, results, and information about participants, clients, providers and employees
Maintains courteous, helpful and professional behavior on the job
Establishes and maintains effective working relationships with co-workers
Follows all Policies and Procedures and HIPAA regulations
Maintains a safe working environment
Supervisory Responsibility: None
Travel: No travel is anticipated for this position
Knowledge, Skills and Abilities:
- High School Diploma or equivalent required.
- Requires a minimum of 5 years of experience with claims processing
- Requires a minimum of 2 years of experience translating business requirements into detailed system specifications
- Requires thorough knowledge of medical terminology, surgical procedures, CPT/HCPCS, and ICD coding methodologies.
- Requires strong ability to apply structure to loosely defined complex problems
- Requires a demonstrated understanding of core business functions
- Requires skillful configuration execution experience and knowledge
- Requires excellent verbal and written communication skills
- Requires strong organizational and analytical skills
- Requires strong MS Office skills, including Excel
- Ability to clearly articulate (both verbal and written) project status and issues management
- Ability to work independently with minimal supervision
- Ability to prioritize effectively
- Ability to consistently multitask
Physical Demands & Requirements:
- Communicates in person and by telephone or video conference with employees, applicants, vendors and others
- Operates a computer and other office productivity machinery, such as a calculator, copy machine, fax machine and office printer
- Remains stationary for extended periods of time
- Occasionally exerts up to 20 pounds of force to lift, carry, push, pull or move objects
- Visual acuity to perform activities such as identifying, inputting and analyzing data on a computer terminal and/or in hard copy
- Occasional reaching to retrieve shelved items
- Occasional bending/stooping
- This position functions within a conversational noise level in an office, or home, environment.
***This is a remote position. Adequate internet speeds and a suitable home-office environment are required for this position. All new team members will be bound by the “Teleworking Agreement’ and must continually meet the terms of the agreement to maintain remote work status.
Supervised by: Assistant Director of Configuration and Provider Network Services
The Company is proud to be an equal opportunity employer. All qualified applicants will receive consideration without regard to ancestry or national origin, race or color, religion or creed, age, disability, AIDS/HIV, gender, marital or family status, pregnancy, childbirth or related medical conditions, genetic information, military service, protected caregiver obligations, sexual orientation, protected financial status or other classification protected by applicable law.
- Pay Type Salary
- Travel Required No
- Telecommute % 100
- Required Education High School
- St. Louis, MO, USA