What are the responsibilities and job description for the Contract Configuration Analyst position at Advanced Medical Management, Inc.?
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
AAP/EEO Statement
It is the policy of Advanced Medical Management to provide equal opportunity for all applicants and employees. The Company does not unlawfully discriminate on the basis of race, creed, color, religion, sex sexual orientation, gender, gender identity, national origin, ancestry, age, medical condition or genetic characteristic, physical or mental disability, family care or medical leave status, military status, pregnancy, marital or domestic partner status, veteran status, or any other status protected by state or federal law.
Job Type: Full-time
Schedule:
- 8 hour shift
- Monday to Friday
Education:
- High school or equivalent (Preferred)
Experience:
- Computer skills: 1 year (Preferred)
Work Location: One location