Contract Configuration Analyst I

TITLE

Contract Configuration Analyst I

POSITION SUMMARY

The Contract Configuration Analyst I will be responsible for supporting all aspects of system configuration ensuring that all system configurations are programmed accurately for Authorizations and Claims.

RESPONSIBILITIES-DUTIES

· Configure rates based on provider contracts to ensure accurate payments of claims and capitations to providers.

· Configure rates based on vendor contracts to ensure accurate payments.

· Maintain system configuration based on data received from contracting

· Audit accuracy of Fee schedules in test environment prior to in-loading in production

· Assign Fee Set Assignments by line of business or health plan code

· Program and audit Interest Payment

· Program and audit RBRVS Geographical Adjustment

· Apply previous experience and knowledge to research and resolve claim/encounter issues, pended claims and update system as necessary

· Coordinating with internal departments to resolve and assist with system related issues/builds

· Other duties may be assigned by the Supervisor of Contract Configuration or Manager of Contract Configuration.

· Ability to handle fluctuating volumes of work and be able to prioritize work to meet deadlines and needs of user community.

EDUCATION & EXPERIENCE REQUIREMENTS

· Minimum 5 years’ of administrative healthcare experience preferred

· High School Diploma or GED, some college preferred

• Experience with benefits and system configuration and interpretation
• Medical terminology, CPT, Revenue codes, ICD10, RBRVS, HCPCS, HIPPS code sets
• Must have experience with all lines of business, Medicare, Medi-Cal, and Commercial claims and know industry guidelines
• Knowledge of software applications such as EZCAP is a plus

· Must be familiar with Microsoft Office (Word, Excel, Outlook, Microsoft, Access, SQL)

• Follow up on assignments, show initiative, be self-motivated, and have a strong work ethic
• Possess strong time management skills, including the ability to prioritize deadlines on multiple projects.
• Produce accurate and high-quality work on time and consistently.
• Individual should also demonstrate the ability to work with all levels of staff within AMM
• Must be highly organized and able to perform multiple tasks efficiently, be computer literate
• Ability to work in a fast-paced environment

· Strong analytical skills and problem solving skills are necessary

· Must obtain a positive attitude and have excellent communication skills

Company Insights

Advanced Medical Management, Inc. (AMM) provides operational, administrative and technical healthcare management services to large physician organizations, government agencies, and health plans. AMM's clients include approximately 2,000 physicians and 75,000 patients in various Independent Physician Associations (IPA). AMM processes more than $100 million annually in healthcare claims and other medical reimbursements. AMM's clients are located all throughout the State of California. AMM is a 33-year-old privately owned company located in beautiful Long Beach, California and currently occupies 18,000 square feet of prime office space adjacent to the Long Beach Airport.

Our mission at AMM is to offer flexible administrative healthcare services that improves patient health, obtains profitability, maintains independence and achieves 5-Star Quality. It is our goal to leave behind a legacy of trusted patient care with integrity. We proudly stand behind our core values and are committed to Quality, Integrity, and Collaboration.

We are looking for a dynamic candidate to join our company whom has excellent work ethic, a desire to contribute to company culture and innovation. This individual must also obtain the drive to succeed and flourish within our organization. The majority of our supervisory and management team have been promoted from within and it is our goal to continue the professional growth of every team member. This is an excellent opportunity for someone seeking a career transition with massive growth potential in the health care industry.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Referral program
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift

Supplemental Pay:

• Bonus pay

Ability to commute/relocate:

• Long Beach, CA 90815: Reliably commute or planning to relocate before starting work (Required)

Experience:

• administrative healthcare: 5 years (Preferred)
• benefits: 1 year (Preferred)

Work Location: One location