System Configuration Analyst

Job Description:

• Coordinate, track, and complete claims and UM-related projects
• Analyze and process complex claim and UM scenarios
• Assist with benefit implementation and claims/UM system configuration
• Coordinate with cross-functional teams to implement and maintain member notifications related to claim and UM decisions and outcomes
• Support research projects and new business implementations as needed
• Partner with management to create, update, and maintain departmental policies and procedures
• Audit and test existing system code rules and provide recommendations for improvement
• Audit and test new and existing benefit setups related to claims and UM adjudication
• Support Crystal Report implementation related to claims and UM activities
• Perform other duties as assigned

Requirements:

• Bachelor’s degree
• Minimum of 2 years of experience in PPO and HMO claims processing, billing, and/or auditing
• Proficiency with Microsoft Office tools, including Word, Excel, and Access
• Strong written and verbal communication and presentation skills
• Advanced analytical skills, including data-mining, reporting, and analysis
• Ability to reason logically, make sound decisions, and communicate effectively under varied circumstances
• Ability to multitask and work efficiently with interruptions or competing priorities
• HSP systems knowledge
• Dental procedure knowledge
• HSP denial explanations knowledge
• Service restrictions knowledge
• Basic data analytics experience
• Prior auditing experience preferred
• Must work in the United States
• No sponsorship available at this time

Benefits:

• Competitive pay structure and savings options
• 401(k) retirement benefits, including employer match, Roth IRA options, immediate vesting during the Safe Harbor period, and access to professional financial advice through Financial Engines
• Affordable medical insurance, with low-cost premiums for employee-only coverage
• 100% employer-paid dental coverage for employees and eligible dependents
• Vision insurance with low-cost premiums for employee-only coverage and dependents
• Company-paid basic life and AD&D insurance equal to one times base salary, with options to purchase additional supplemental coverage
• Flexible Spending Accounts for healthcare and dependent care expenses
• Voluntary benefit programs, including accident, critical illness, and hospital indemnity insurance
• Long-term disability coverage
• Expansive wellness programs, including company-wide wellness challenges, BurnAlong memberships, and gym discounts
• Employee Assistance Program (EAP) to support mental health and well-being
• Generous vacation and sick leave policies, with ability to roll over unused time
• 10 paid company holidays
• Tuition reimbursement for eligible educational expenses
• Remote or hybrid work options available for various positions