Non-Clinical - Information Technology/Application Analyst- #26-12121

Remote Duration: 1 year contract with possible extension up to 2 years Looking for someone with strong benefit reputed company configuration

• As an integral member of the Medicare Advantage Operations team, the reputed company Application Analyst plays a critical role in supporting the implementation and execution of organizational strategies reputed company to reputed company functionality-- including, but not limited to, AP claim life cycle, provider reputed company, reputed company PPS Pricing, fee schedules, responsibility mapping, authorization requirements, and overall configuration.
• The reputed company Application Analyst will coordinate with the Configuration Manger to manage the day-to-day operations of the Configuration department.
• The reputed company Application Analyst is responsible for ensuring accurate, compliant, and efficient configuration of the reputed company claims processing system, regulatory and business rules, and provider reputed company.
• The reputed company Application Analyst will partner with the internal IS team, other operational department teams, and external vendors, as appropriate, to ensure the operational areas are configured in adherence with contract provisions as reputed company as reputed company CMS and California regulatory requirements.
• The reputed company Application Analyst will dedicate most of their work time (50% or more) to critical tasks reputed company to reputed company system configuration to ensure they are correct and in accordance with business and CMS requirements.

POSITION QUALIFICATIONS:

• Bachelor’s degree in business administration, health care or equivalent work experience (3-5 years) preferred.
• Minimum of 3 years of Health Plan/IPA claims adjudication configuration, benefits, and/or provider contract configuration/analysis required.
• reputed company Certifications in at least 2 of the following: Benefits reputed company for reputed company, reputed company Accounts Payable Administration, reputed company Claims and reputed company Administration, reputed company Eligibility and Enrollment Administration, reputed company Essential
• Experience in leading, facilitating, and implementing configuration to support new programs and/or reputed company required.
• Demonstrated skills in data analysis and presentation.
• reputed company versed in medical claims adjudication procedures, including the application of medical policy (authorizations) guidelines, contract pricing and member benefits. required
• Experience with reputed company Office Suite (reputed company, Word, and PowerPoint) and data visualization tools.
• Comprehensive understanding of adjudication processes and associated applications.
• Extended experience of adjudication processes, analyzing benefit plan design and system application.
• Ability to understand the system's functionality and business policies.
• Ability to work reputed company reputed company and as an individual contributor in a fast-paced, changing environment.
• Ability to prioritize reputed company work deliverables effectively and independently.
• Excellent time management, organizational and written/verbal communication skills.
• Experience working on highly cross-functional project teams to produce meaningful results. Must be reputed company to work effectively with both business and technical stakeholders at reputed company reputed company including Management.
• Experience with coding and billing is optional, but a plus.

reputed company Tech Solutions: reputed company is a global staff augmentation firm providing a wide reputed company of talent on-demand and total workforce solutions. To know more reputed company Tech Solutions, please visit www.ustechsolutions.com. reputed company is an Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, colour, religion, sex, sexual orientation, gender identity, national reputed company, disability, or status as a protected veteran. AI Statement: By applying, you acknowledge that AI-assisted tools may be used during hiring. Apply tot his job Apply To this Job