DMBA is looking for a Configuration Systems Analyst. This position performs configuration activities to efficiently and accurately adjudicate claims according to the plan documents. Helps configure business rules to support reimbursement policies and methodologies.

Contributor in implementation of and changes to existing health plan business (regulatory and organizational compliance, medical policy implementation, product line changes, HIPAA, EDI). Guide, train and advise business users and team members with aid in problem resolution. Performs simple analytical duties for claims and provider pricing. Acts as a liaison between Configuration and other company departments.

This is a great position for someone who wants to make a difference!

Duties include, but are not limited to:

• Coordinate the entry, testing, validation and migration of the configuration business rules into the Test and Live DMBA core adjudication environments.
• Ensure the prompt and correct loading of applicable data and data elements, including, but not limited to, fee schedule rates and system code set variables (e.g., new/changed/deleted procedure and diagnosis codes, modifiers, DRG, etc.)
• Provide ongoing quality improvement efforts to ensure that opportunities for system efficiencies are explored and developed with technical aid.
• Supplies application and technical support for the AMISYS and clinical editing software as well as troubleshooting for end users.
• Finds, researches and resolves inaccuracies and inconsistencies in the business rules as they impact claims payment and other upstream and downstream transactions.
• Participate in the business aspect of system conversions and upgrades, including testing of new or enhanced features. Assist to create test case scenarios for application and configuration testing that ensures appropriate testing has been completed before the software enters the production phase.

Skills and/or qualifications

• Demonstrated knowledge of, and ability in Word, Excel, Visio, SQL
• Ability to handle multiple tasks. Demonstrated organization skills and attention to detail.
• Ability to adapt to varied situations requiring constructive thinking, analysis, interpretation and evaluation.
• Ability to practice judgement and problem solve in a calm, logical, technical, prompt, and correct manner.
• Ability to sit at a desk or computer station most of the time.
• Ability to self-manage specific projects related to areas of responsibility without excess management.

Required Experience

• 2+ years HealthCare operations or Healthcare claims processing experience

Preferred Experience

• Proficiency in Healthcare transactions and Health Plan terminology, medical coding (e.g., CPT, HCPCS, ICD9, CDT, Revenue, DRG and other relevant medical and industry-standard codes)
• 1-3 years proven configuration experience, preferably on Facets, HealthRules, Diamond, Amisys Advance or similar payer system.

What We Offer

• Competitive pay
• Rich medical, vision and dental benefits with low premiums (we are the #1 health plan in Utah!)
• Rich retirement planning; including 401(k) company match, life insurance, and full-service Financial Planners onsite at no cost
• Generous paid leave plan that starts accruing your first day, your birthday off, additional sick leave and 11 paid holidays
• World class wellness program with health coaching, ability to earn 3 additional days off a year, fun activities, and onsite gym.
• Tuition reimbursement.
• Career development through company sponsored programs and over 5000 on-demand online training courses through our learning management system.