Business Configuration Analyst

Specific Duties
• Configures and maintains the business rules within the claims adjudication ecosystem.
• Configures the HealthRules software from development into the testing and production phases.
• Provides application and technical support for the HealthRules software as well as troubleshooting for end users.
• Identifies researches and resolves inaccuracies and inconsistencies in the business rules as they impact claims payment and other upstream and downstream transactions.
• Engages in intake with business clients to evaluate business requirements.
• Recommends and implements benefit setup based on knowledge of system configuration capabilities and information obtained from business clients.
• Independently evaluates business procedures and problems.
• Participates in business requirements gathering sessions to identify specifications and solutions.
• Creates test case scenarios for application and configuration testing and ensures appropriate testing has been completed before the software enters the production phase.
• Identifies and assesses potential problems and performs and implements system enhancements, modifications and upgrades.
• Defines with business client data reporting and trending reports and makes recommendations to management.
• Designs and develops user system documentation.
• Works with IT to define business systems requirements.
• Performs investigation, evaluation and documentation of system design findings.
• Evaluates and monitors coded data elements.
• Assists users in understanding business system functions.
• Additional duties as assigned.

Knowledge Summary
• Must have a thorough understanding of the configuration of business rules that support reimbursement policies and methodologies, member/provider contracts, and claims adjudication and correspondence.
• Must have demonstrated strong analytical, technical and problem-solving skills.
• Ability to work with multiple business systems and have a good understanding of system design.
• Demonstrated experience in Microsoft office products and project management tools.
• Strong communication and analytical skills required to covey complex technical ideas, concepts and applications.
• Must understand the business environment and associated systems.
• Must be detail oriented and understand corporate objectives.
• Must have the ability to follow through on project life cycles.
• Experience in data analysis, testing and implementation.
• Technical writing skills needed.
• Must be able to present findings to management.
• Must be able to create time-lines and work with internal and external departments to gather appropriate information.
• Skills in coaching and mentoring.
• Works independently on projects, identifies and implements business systems solutions with minimal supervision.
• Good understanding of available resources to investigate, perform testing, analyze and present initial findings.
• Strong presentation skills required.
• Knowledge of project management tools and business system methodology
• Proficiency in Healthcare and Health Plan terminology, medical coding (e.g., CPT, HCPCS, ICD9, CDT, Revenue, DRG and other relevant medical and industry-standard codes)

Education & Experience
• Bachelor's degree in business administration, Management Information Systems, Computer Science or equivalent work experience.
• In lieu of degree, minimum 3-4 years proven configuration experience, preferably on Facets, Health Rules, Diamond, Amisys Advance or similar payer system Strong project management skills needed.
• 2+ years HealthCare operations or Healthcare claims processing experience

Hybrid

Independence has implemented a "Hybrid" model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the "Hybrid" model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.