Job Description :
Position Title: Configuration Analyst II
Location: Newark, NJ
Approximate Duration: 3 Month CTH
Job description:
The Configuration Analyst II is responsible for gathering requirements from internal and external clients, providing business and technical expertise in support of the business area. The Configuration Analyst II will provide configuration expertise during the design/build sessions to find the most appropriate solution as well as ensure the proposed solutions support and enhance business operations. Specifically, the Configuration Analyst II elicits, analyzes, performs preliminary testing, communicates and validates requirements for changes to business processes, policies and transaction processing system by creating Functional and Configuration documentation including development, technical and implementation. This person is responsible for ensuring that all tasks are completed in a timely and accurate manner including receiving proper approvals through all control boards. This person works at a senior level of activity and work process coordination and functions independently within authorized limits. May partner with external areas to coordinate work and ensure that deliverables are met and that guidelines/policies are followed.
Job Responsibilities:
Identifies pricing and configuration issues and recommends solutions to solve gaps between external expectations and system limitations, suggesting configuration improvements or streamlined maintenance processes. Initiates error correction and claim re-adjudication related to fee schedule, contract configuration, and other file discrepancies.
Develops test plans and completes file, data, and logic validation while performing user acceptance testing for updates instituted by Vendor. Performs post-implementation validation of all related changes moved into the production environment.
Develops business specifications for RFAs, ASO inquiries, and other requests, recognizing any gaps and deficiencies and making recommendations to enhance current processes.
Serves as department subject matter expert (SME) while attending sessions on benefits reimbursement, policy development, configuration, and other committees/meetings with business owners and assist with the development of complete business requirements for configuration projects.
Assists with the development of Business Configuration Analysts job aids, training materials, reference guides, and other documentation. Train other Analysts/Consultants/Temps as needed for assistance on assigned projects.
Analyzes complex provider contracts and design/configure provider agreements, including validation of configuration and peer review.
Assists manager in prioritizing unit activities identifying those items which are critical to client’s business operations as highest priority.
Researches and resolves audit related inquiries, determines root cause of payment discrepancies, and reports all findings to Manager.
Updates and maintains key inventory logs for management review to assist with inventory controls and quality audits.
Assists vendor with the configuration of edits, CPT/HCPCS & ICD10 procedure and diagnosis codes, place and service code mapping annually or as required for accurate claims processing.