Configuration System Analyst II – Facets, Benefits Configuration
CareSource
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $64,980 - $103,950 per year
Job Level
Mid-LevelSenior
About the role
- Leads and defines system requirements associated with Member Benefits, Provider Reimbursement and payment systems
- Identify, manage and document the status of open issues
- Develop and utilize reports to analyze and stratify data
- Plan/implement new software releases including testing and training
- Serve as liaison between IT and business areas
- Lead review of benefits or provider reimbursement
- Lead in the development and execution of test plans and scenarios
- Audit configuration to ensure accuracy and minimize fraud and abuse
Requirements
- High School Diploma or GED is required
- Bachelor’s Degree or equivalent years of relevant work experience is preferred
- Minimum of three (3) years health plan experience
- Two (2) years of configuration or clinical editing software experience is required
- Exposure to Facets is preferred
- Advanced computer skills with Microsoft Word, Excel, Access, Visio and abilities in Facets
- Proven understanding of database relationships required
- Understanding of DRG and APC reimbursement methods
- Understanding of CPT, HCPCs and ICD-CM Codes
- Knowledge of HIPAA Transaction Codes
- Critical listening and thinking skills
- Decision making/problem solving skills
- Customer service oriented
- Facets knowledge/training
- Proper claim coding knowledge
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
configuration softwareclinical editing softwaredata analysistest plansdatabase relationshipsclaim codingCPT codesHCPCs codesICD-CM codesreimbursement methods
Soft skills
critical listeningcritical thinkingdecision makingproblem solvingcustomer service
Certifications
High School DiplomaGEDBachelor's Degree