Ensure mapping and testing behind the scenes and maintain Matrix of Benefit Packages Responsible for provider records configuration and contract rate load create vendors, practice locations, medical ...
Ensure mapping and testing behind the scenes and maintain Matrix of Benefit Packages Responsible for provider records configuration and contract rate load create vendors, practice locations, medical ...
Healthcare Configuration and Data Integrity Manager
Miami, FL · On-site
$60K - $70K/yr
Ensure mapping and testing behind the scenes and maintain Matrix of Benefit Packages Responsible for provider records configuration and contract rate load create vendors, practice locations, medical ...
Healthcare Configuration and Data Integrity Manager
Miami, FL · On-site
$60K - $70K/yr
Ensure mapping and testing behind the scenes and maintain Matrix of Benefit Packages Responsible for provider records configuration and contract rate load create vendors, practice locations, medical ...
Benefit Config Analyst I
Portland, OR · On-site
Performs quality assurance testing on test claims to validate benefit configuration will meet the needs of the Medical or Dental Claims departments. * Evaluates and resolves benefit configuration ...
Quick apply
Benefit Config Analyst I
Portland, OR · On-site
Performs quality assurance testing on test claims to validate benefit configuration will meet the needs of the Medical or Dental Claims departments. * Evaluates and resolves benefit configuration ...
Director, Configuration
$175K - $216K/yr
Duties Continued Oversees benefit configuration, pricing methodologies, provider reimbursement ... testing protocols, document standards, and best practices. Experience supporting audits, corrective ...
Director, Configuration
$175K - $216K/yr
Duties Continued Oversees benefit configuration, pricing methodologies, provider reimbursement ... testing protocols, document standards, and best practices. Experience supporting audits, corrective ...
Director, Configuration
Los Angeles, CA · On-site
$175K - $216K/yr
Duties Continued Oversees benefit configuration, pricing methodologies, provider reimbursement ... testing protocols, document standards, and best practices. Experience supporting audits, corrective ...
Director, Configuration
Los Angeles, CA · On-site
$175K - $216K/yr
Duties Continued Oversees benefit configuration, pricing methodologies, provider reimbursement ... testing protocols, document standards, and best practices. Experience supporting audits, corrective ...
... benefit configuration and claims platform operations across all core systems. This role is ... Oversee test strategy (e.g., UAT, regression, negative testing) internal to Configuration to ensure ...
... benefit configuration and claims platform operations across all core systems. This role is ... Oversee test strategy (e.g., UAT, regression, negative testing) internal to Configuration to ensure ...
Configuration Developer - Analyst
Colorado Springs, CO · Remote
$75K - $90K/yr
Perform unit and integration testing to validate accuracy and quality of configured business rules ... Employees also receive a comprehensive benefits package that includes an employer matched ...
Configuration Developer - Analyst
Colorado Springs, CO · Remote
$75K - $90K/yr
Perform unit and integration testing to validate accuracy and quality of configured business rules ... Employees also receive a comprehensive benefits package that includes an employer matched ...
Configuration Developer - Analyst
Colorado Springs, CO · Remote
$75K - $90K/yr
Perform unit and integration testing to validate accuracy and quality of configured business rules ... Employees also receive a comprehensive benefits package that includes an employer matched ...
Configuration Developer - Analyst
Colorado Springs, CO · Remote
$75K - $90K/yr
Perform unit and integration testing to validate accuracy and quality of configured business rules ... Employees also receive a comprehensive benefits package that includes an employer matched ...
Coordinate configuration, testing, defect management, and release activities with project teams ... Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana ...
Coordinate configuration, testing, defect management, and release activities with project teams ... Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana ...
REMOTE Health Plan Configuration Analyst
Houston, TX · Remote
$45 - $47/hr
... testing, and optimization of enterprise Health Plan systems. This role focuses on translating ... Benefit packages for this role will start on the 31st day of employment and include medical, dental ...
Quick apply
REMOTE Health Plan Configuration Analyst
Houston, TX · Remote
$45 - $47/hr
... testing, and optimization of enterprise Health Plan systems. This role focuses on translating ... Benefit packages for this role will start on the 31st day of employment and include medical, dental ...
Responsibilities - Lead end-to-end configuration, testing, and deployment of updates in Workday ... Benefits - Opportunity to convert to full-time in a high-impact role. - Work with cutting-edge ...
Responsibilities - Lead end-to-end configuration, testing, and deployment of updates in Workday ... Benefits - Opportunity to convert to full-time in a high-impact role. - Work with cutting-edge ...
Workday Benefit Systems Analyst
Phoenix, AZ · Hybrid
$60K - $105K/yr
Responsible for full cycle testing, which includes planning, case development, execution, and coordination of testers for configuration, reporting, and/or integrations * Work closely with Benefit ...
Workday Benefit Systems Analyst
Phoenix, AZ · Hybrid
$60K - $105K/yr
Responsible for full cycle testing, which includes planning, case development, execution, and coordination of testers for configuration, reporting, and/or integrations * Work closely with Benefit ...
Manage and support initiatives to focus on projects with plan wide benefit in accordance with ... configuration, testing and accuracy * Manage activities and communications between key business ...
Manage and support initiatives to focus on projects with plan wide benefit in accordance with ... configuration, testing and accuracy * Manage activities and communications between key business ...
Manager of Provider Contract Configuration
New York, NY · Remote
$130K - $140K/yr
Manage and support initiatives to focus on projects with plan wide benefit in accordance with ... configuration, testing and accuracy * Manage activities and communications between key business ...
Manager of Provider Contract Configuration
New York, NY · Remote
$130K - $140K/yr
Manage and support initiatives to focus on projects with plan wide benefit in accordance with ... configuration, testing and accuracy * Manage activities and communications between key business ...
... testing, and go-live-on a modern low-code/no-code SaaS platform. In this role, you'll act as a ... Benefits About Resource Innovations Resource Innovations (RI) is a women-led energy transformation ...
... testing, and go-live-on a modern low-code/no-code SaaS platform. In this role, you'll act as a ... Benefits About Resource Innovations Resource Innovations (RI) is a women-led energy transformation ...
Director of TPA Operations
Miami, FL · On-site
$100K - $120K/yr
Direct benefit configuration and claims system governance, translating health plan contracts ... testing, and release validation. Provide senior-level operational leadership and escalation ...
Director of TPA Operations
Miami, FL · On-site
$100K - $120K/yr
Direct benefit configuration and claims system governance, translating health plan contracts ... testing, and release validation. Provide senior-level operational leadership and escalation ...
SaaS Configuration Lead
Chicago, IL · Remote
... testing, and go-live--on a modern low-code/no-code SaaS platform. In this role, you'll act as a ... Benefits About Resource Innovations Resource Innovations (RI) is a women-led energy transformation ...
Quick apply
SaaS Configuration Lead
Chicago, IL · Remote
... testing, and go-live--on a modern low-code/no-code SaaS platform. In this role, you'll act as a ... Benefits About Resource Innovations Resource Innovations (RI) is a women-led energy transformation ...
SaaS Configuration Lead
Boston, MA · Remote
... testing, and go-live--on a modern low-code/no-code SaaS platform. In this role, you'll act as a ... Benefits About Resource Innovations Resource Innovations (RI) is a women-led energy transformation ...
Quick apply
SaaS Configuration Lead
Boston, MA · Remote
... testing, and go-live--on a modern low-code/no-code SaaS platform. In this role, you'll act as a ... Benefits About Resource Innovations Resource Innovations (RI) is a women-led energy transformation ...
... testing, and go-live-on a modern low-code/no-code SaaS platform. In this role, you'll act as a ... Benefits About Resource Innovations Resource Innovations (RI) is a women-led energy transformation ...
... testing, and go-live-on a modern low-code/no-code SaaS platform. In this role, you'll act as a ... Benefits About Resource Innovations Resource Innovations (RI) is a women-led energy transformation ...
Sr. Configuration Center Technician (Req #1293)
Chandler, AZ · On-site
$28.90 - $36.05/hr
The position is responsible for the preparation, setup, configuration, testing, consolidation, and ... Details of participation in these benefit plans will be provided if an offer of employment is ...
Sr. Configuration Center Technician (Req #1293)
Chandler, AZ · On-site
$28.90 - $36.05/hr
The position is responsible for the preparation, setup, configuration, testing, consolidation, and ... Details of participation in these benefit plans will be provided if an offer of employment is ...
Benefit Configuration Tester information
See salary details
$18.51 - $26.49
21% of jobs
$26.49 - $34.46
0% of jobs
$34.46 - $42.44
0% of jobs
$43.67 is the 25th percentile. Wages below this are outliers.
$42.44 - $50.42
27% of jobs
The median wage is $53.07 / hr.
$50.42 - $58.39
6% of jobs
$58.39 - $66.37
5% of jobs
$66.37 - $74.34
6% of jobs
$78.12 is the 75th percentile. Wages above this are outliers.
$74.34 - $82.32
20% of jobs
$82.32 - $90.30
7% of jobs
$90.30 - $98.27
2% of jobs
$98.27 - $106.25
5% of jobs
$18
$59
$106
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$60K - $70K/yr
Other
Medical
Posted 2 days ago
Job description
Description
Position Summary
The Configuration and Data Integrity Manager is responsible for implementing and interpreting the organization's overall claims, provider configuration, eligibility and provider database management, security, and operations. The Configuration Manager will work with internal departments and external organizations to assure secure data exchanges, integrity, reliability, and availability; plans, organizes and coordinates activities related to the analysis and implementation of network database systems; provides technical guidance and database compliance audits; and consults with business users regarding the use and management of data.
Duties and Responsibilities
Responsible for benefit configuration covered services, copay, deductibles, coinsurance and max out of pocket in TPA system. Ensure mapping and testing behind the scenes and maintain Matrix of Benefit Packages
Responsible for provider records configuration and contract rate load create vendors, practice locations, medical group, networks, reimbursement rate. Collaborate with Provider Relations Department and Credentialing to ensure Responsible for work distribution and resource management of configuration specialist and data integrity specialist.
Configuration support to provider contracts-question if specific agreement received can be entered as noted.
Conduct unit testing to ensure design meets specifications as it relates to product upgrades or new releases.
Responsible for accurately interpreting specific contracts as well as additional business requirements and converting these terms to configuration parameters.
Quality control of all information uploaded in TPA system, i.e., Provider data, fee schedules, network assignment, team member's responsibilities.
Collaborate with provider call center, clinical and claims department when asked to verify specific provider configuration or benefit configuration information.
Provide system configuration support to organization based on changing business needs.
Review and recommend changes to existing configuration processes.
Analyze and resolve Claims Workflow regarding Benefit & Contract configuration issues in a in with 3 business days.
Provide technical guidance to Data Integrity Specialist in their assigned job duties.
Oversee Configure Medicare/Medicaid/Commercial interest rates in TPA system.
Resolve Eligibility Issues with Health Plans.
Validate reports ran by Data Integrity Specialist on a weekly, monthly, and quarterly basis.
Load and Maintain Fee Schedule in TPA System
Act as liaison between Corporate and the health plan regarding programming development needs related to reporting.
Requirements
Knowledge
3-5 years of Claims Processing experience required.
1-2 years' experience in healthcare data management.
Broad knowledge of medical terminology, customer service, claims processing and/or customary and reasonable cost containment, and coordination of benefits and diagnosis coding.
Skills
Advanced knowledge of Microsoft applications: Outlook, access database, excel, word and basic computer navigation.
About Provider Network Solutions
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
1 - 10 Employees
Headquarters location
Doral, FL, US
Year founded
1998