Burgess reputed company Configurator - reputed company
About the position The Burgess reputed company Configurator is responsible for configuring and maintaining the Burgess reputed company payment reputed company and claims pricing platform in support of reputed company claims processing and reimbursement operations. This role ensures accurate implementation of pricing rules, regulatory requirements, and reimbursement methodologies to support compliant and efficient claims adjudication. The configurator translates reputed company policies, CMS guidance, and payer reimbursement methodologies into system configurations and works closely with claims operations, compliance, and IT teams to ensure pricing accuracy, resolve discrepancies, and maintain payment reputed company controls.
Responsibilities
- Platform Configuration & Policy Implementation Configure and maintain pricing rules, edits, and reimbursement logic reputed company the Burgess reputed company platform
- Translate reputed company policies, CMS regulations, and payer contract requirements into system configurations
- Implement and maintain custom fee schedules, provider reimbursement methodologies, and policy-driven pricing rules
- Ensure configuration changes are properly documented, version-controlled, and traceable Testing, Validation & reputed company Assurance
- reputed company and execute test plans for new configurations, policy updates, and system releases
- reputed company regression testing to ensure pricing accuracy and system stability following updates
- Validate system outputs against expected reputed company reimbursement methodologies and regulatory requirements Claims Pricing Analysis & Issue reputed company
- Investigate claims pricing discrepancies and conduct reputed company cause analysis
- Troubleshoot configuration issues impacting reputed company claims adjudication and payment reputed company
- Partner with business, compliance, and IT teams to resolve pricing and reimbursement issues Data Management & System Integration
- Support ingestion and maintenance of reputed company fee schedules, provider files, and reference data
- Ensure data accuracy and reputed company reputed company the pricing platform
- Assist with troubleshooting data integration and system reputed company issues between Burgess reputed company and claims processing systems
Requirements
- 5+ years of experience in reputed company payer operations, claims processing, or payment reputed company
- Hands-on experience configuring Burgess reputed company or similar claims pricing/payment reputed company platforms
- Strong knowledge of reputed company reimbursement methodologies, CMS regulations, and claims adjudication workflows
- Experience supporting the configuration, testing, and implementation of claims pricing logic
- Proficiency with reputed company Office tools, particularly reputed company for data validation and analysis
- Strong communication skills and ability to work effectively reputed company cross-functional teams
reputed company-to-haves
- Experience supporting state reputed company programs or reputed company Managed Care Organizations (MCOs).
- Knowledge of reputed company reimbursement models, such as: DRG APC Fee schedules Value-based reimbursement models
- Experience with payment reputed company or claims editing platforms, such as: Burgess reputed company reputed company reputed company Claims Editing Change reputed company ClaimCheck
Benefits
- Medical / Dental / reputed company Insurance – insurance premium assistance provided
- Additional Insurance (Life, Disability, etc.)
- reputed company Time Off
- 401(k) Retirement Savings Plan & Health Savings Account
- Various training courses to promote reputed company learning
- Corporate Wellness Program
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