Configuration Analyst
HealthNow New York Inc. - Blue Bell, PA

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Position Summary: Responsible for planning and executing the implementation of products and clients. This includes assessing and planning for needs to support enrollment, billing, and reporting.

Primary Job Duties:
  • System Configuration set-up to support current operations and new market growth: Configuration and maintenance of end-user accounts, permissions and access rights; Configuration of all vendor entities; Configuration and maintenance of system workflow engines; Configuration and maintenance of EDI entities; Configuration and execution of system utilities and scheduled jobs; Coordination of product change implementations. Benefit Administration Configuration: Build and maintain system claim adjudication logic rules and schedules; Build and maintain medical and secondary benefit plans for client base. (30%)
  • Enrollment/Membership Configuration: Build and maintain enrollment configuration rules; Build and maintain enrollment validation and translation parameters. Group/Member Premium Configuration: Build and maintain broker, carriers & banking entities; Setup and maintain billing plans, rates, factors ; Setup and maintain billing control parameters, configuration parameters; Setup and maintain billing statements for client base; Setup and maintain broker and carrier commissions/payouts. (20%)
  • Provider and PPO Network Configuration: o Demonstrated knowledge of HIPAA Health Care provider taxonomy codes o Setup and maintain provider and PPO network entities. (10%)
  • CRM Configuration: Build and maintain master CRM settings; Build and maintain needed workflow queues to route CRM tasks and calls. (10%)
  • Setup and maintain the use of system logos, formats, signatures, etc. (10%)
  • Manage all 1099 responsibilities. Maintenance of various files and documentation, utilizing software such as Word, Excel, Access and Visio.(10%)
  • Developing and establishing quality assurance standards and measures for the configuration of the Eldorado Hpac claim system and ensuring optimal performance of the claim system functionality in alignment with the production goals. (10%)
Required Skills Primary Skills/Knowledge:
  • Knowledge of health plan operations in regards to information system, system configuration and testing philosophies
  • Demonstrated experience interpreting benefit, authorization and claim rules
  • Demonstrated knowledge of claim coding and payment principles and contract configuration
  • Knowledge of best-practices regarding privacy, security and regulatory compliance
  • Experience documenting and maintaining configuration and process information
  • Good understanding of the organization's expectations of the HealthPac / Javelina software solution
  • Working technical knowledge of current system software, protocols and standards, include FTP/PGP encryption and EDI transaction sets
  • Knowledge of BCI's SAS70 auditing processes
  • Strong interpersonal and oral communication skills
  • Customer Service oriented
  • Ability to present ideas and solutions in user-friendly language
  • Highly self motivated and directed
  • Keen attention to detail
  • Skills at working within a team-oriented, collaborative environment
Required Experience Preferred Education: Bachelors Degree (N/A)

Preferred Experience: Bachelors degree and/or 5-8 years of relevant work experience. Experience with Eldorado?s HealthPac / Javelina health benefit management software solutions.

Working Conditions: Required Licenses/Certifications:

About this company
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HealthNow New York Inc. is one of New York’s leading health care companies that provide access to quality health care and innovative...