Seeking an experienced BPO Configuration Analysis Senior Specialist to join our team. This role is pivotal in ensuring accurate client system configuration for pricing and provider contracts within a new claims processing platform. Responsibilities include evaluating requirements, developing configuration approaches, and implementing advanced functionalities based on best practices. You will play a key part in problem-solving for various health plan benefits, provider issues, pricing discrepancies, and operational challenges.

This position involves performing diverse tasks focused on resolving production support issues by analyzing client configurations with our core administrative system. Support extends to updating configurations, particularly in provider pricing. You will also manage fee schedule changes, including terms, affiliations, and contract maintenance. Additionally, you will enable User Acceptance Testing (UAT) and implement necessary modifications based on stakeholder feedback. This role requires creating manual test cases and resolving coding/QA issues by managing issue logs and addressing high-priority change requests.

A strong focus on data validation and auditing of existing plans and contracts within client databases is essential. This includes comprehensive database management and maintenance. The ideal candidate will possess over 5 years of experience in the US healthcare claims payer domain and significant expertise in client system configuration for pricing and UAT testing.

Configure client systems for pricing (provider contracts) according to requirements and business rules for the new claims processing platform. Evaluate configuration needs, formulate approaches, and integrate advanced functionalities and best practices. Assess business requirements and rules to create and complete configuration activities. Participate in resolving issues related to health plan benefits, providers, pricing, operations, and systems. Address production support issues by analyzing client configurations within the core administrative system. Support configuration updates, particularly in provider pricing, and manage fee schedule changes, terms, affiliations, and contract maintenance. Enable User Acceptance Testing (UAT) and implement modifications as advised by business owners and analysts. Create manual test cases from use cases and functional specifications. Resolve coding/QA issues, manage Master Issue Logs, and fix high-priority change requests. Conduct data validation and audit existing plans and contracts in client databases. Perform database management and maintenance tasks.

Over 5 years of overall experience within the US healthcare claims payer industry. 6+ years of experience configuring client systems for pricing (provider contracts) and 2+ years in UAT testing. A high school diploma or equivalent is required; an Associate's degree, technical college coursework, or some college credits are preferred. Demonstrated ability to thrive in a project-oriented environment.

Preferred qualifications include:

2+ years of experience with SQL, including query writing. Exposure to VB/Vb.net.