Configuration Specialist

<strong>Working at Advantasure is more than a job &mdash; you&rsquo;re part of a team that is becoming the country&rsquo;s leading healthcare solutions provider.<br /></strong><br /><strong>A career at Advantasure means you&rsquo;ll be part of one of the most dynamic, diversified and innovative healthcare companies in the nation. You&rsquo;ll be helping our clients make their members healthier &mdash; and our communities a better place to call home.</strong>

United States, USA


<p class="p1"><strong>At Advantasure, we partner with healthcare clients to simplify their operations and accelerate their business success. Powered by our broad expertise and a comprehensive suite of product and service solutions, we help health plans effectively navigate the complexity of healthcare.</strong></p>

keywords: job description,analysis,compliance,support,education,experience,knowledge,skills

Full Time

Competitive Compensation and Benefits Package

Overview: <br />The Configuration Specialist is responsible for coordinating the development and implementation of programs and strategies to improve service to customers in the area of system configuration.<br /><br /> <p><strong>WORKING CONDITIONS:</strong></p> <p>Work is performed in an office setting with no unusual hazards. Travel is required.</p>
Responsibilities: <br /> <ul> <li>Configures benefit system(s) with precision on both an annual and ongoing basis.</li> <li>Responsible for running claims through the system(s) in multiple real-life scenarios to ensure consistency in running and reporting claims, and to ensure compliance with both State and Federal CMS and Medicare Advantage regulations.</li> <li>Develops and improves workflows and business processes within area(s) to improve customer service, decrease operational costs, and improve overall quality.</li> <li>Identifies and/or analyzes business problems and devises procedures for solutions to the problems.</li> <li>Effectively leads projects and teams in order to produce desired results.</li> <li>Responsible for corporate communication of project results.</li> <li>Develops and implements standard policies and procedures for providing routine service.</li> <li>Assures that corporate compliance is communicated, implemented, and monitored on an ongoing basis.</li> <li>Participates in systems testing, develops procedures and controls, and provides recommendations for the ongoing improvement of the updated process.</li> <li>Assists personnel, both internally and externally, by answering questions, supplying information, and training in the area of system configuration and setup.</li> <li>Develops and maintains an effective working relationship with customers.</li> <li>Interprets and puts into production CMS changes.</li> </ul>
Requirements: <br /> <p><strong>EDUCATION:</strong></p> <ul> <li>Bachelor&rsquo;s degree in Business Administration, Computer Science, Information Technology, Health Care, or a related field.</li> <li>Relevant combination of education and experience may be considered in lieu of degree.&nbsp;</li> <li>Continuous learning, as defined by the Company&rsquo;s learning philosophy, is required.&nbsp;</li> <li>Certification or progress toward certification is highly preferred and encouraged.</li> </ul> <p>&nbsp;</p> <p><strong>EXPERIENCE:</strong></p> <ul> <li>Five years experience in claims configuration software is required. &nbsp;</li> <li>Supervisory and/or Analyst experience with proven experience in operational analysis, data analysis, and problem resolution type activities is preferred.</li> </ul> <p>&nbsp;</p> <p><strong>SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:</strong></p> <ul> <li>Ability to plan, organize, direct, and control projects.</li> <li>Excellent written and verbal communication skills.</li> <li>Ability to lead and contribute to process improvement projects.</li> <li>Working knowledge of PC applications and/or mainframe.</li> <li>Excellent analytical, organizational, and problem-solving skills.</li> <li>Knowledge of Project work with the ability to meet deadlines, understand requirements, and support business deliverables.</li> <li>Ability to work successfully as both a team player and an individual contributor with little supervision.</li> <li>Ability to manage multiple priorities.</li> <li>Claims processing knowledge.</li> <li>Significant creativity to utilize system capabilities to meet benefit design.</li> <li>Ability to develop, implement, and monitor policies and procedures.</li> <li>Proficient in current industry standard PC applications and systems (e.g., Access, Excel, and Word).</li> <li>Ability to travel to business locations.</li> <li>Ability to manage vendors.</li> <li>Ability to demonstrate strong analytical skills and display the &ldquo;own it&rdquo; cultural belief on a daily basis.</li> <li>Knowledge of benefit/claims configuration of facets, Advantasure, or equivalent, for claims and enrollment systems.</li> <li>Knowledge of Medicare Advantage and CMS Regulations.</li> <li>BlueCard knowledge.</li> <li>Knowledge of claims in a Medicare Advantage Organization.</li> <li>Knowledge and expertise in Configuration.</li> </ul>