Advance your career as a Configuration Analysis Senior Specialist within the US healthcare claims payer industry. This role is central to configuring client systems for pricing, specifically provider contracts, aligning with new claims processing platform business rules.

We seek professionals adept at evaluating configuration requirements, formulating strategic approaches, and integrating advanced functionalities. Your expertise will be crucial in transforming business requirements into effective configuration solutions, ensuring compliance with best practices.

This position also involves active participation in troubleshooting Health Plan benefit, provider, pricing, and system-related issues. You will perform diverse tasks to resolve production support challenges, leveraging your deep understanding of client configurations within core administrative systems.

Key responsibilities include configuring client systems for pricing (provider contracts) according to business rules for a new claims processing platform.

You will evaluate configuration needs, develop configuration approaches, and implement advanced functionalities. This involves translating business requirements and rules into concrete configuration activities.

Engage in problem-solving for health plan benefits, provider issues, pricing discrepancies, and operational system challenges. Support the resolution of production issues impacting client configurations and contribute to updating the core claims processing system, particularly in provider pricing.

Manage fee schedule changes, including terms, affiliations, and contract maintenance. Facilitate User Acceptance Testing (UAT) and implement modifications based on business owner feedback. Create test cases from various requirement documents and resolve coding/QA issues by managing issue logs and addressing high-priority change requests.

Additionally, perform data validation and audits of existing plans and contracts within client databases, alongside database management and maintenance.

Ideal candidates possess over 5 years of overall experience in the US healthcare claims payer domain.

This role requires 6+ years of experience in configuring client systems for pricing (provider contracts) and 2+ years in UAT testing.

A high school diploma or equivalent is mandatory. An Associate's degree, technical college coursework, or some college credits are preferred.

Demonstrated ability to thrive in a project-oriented environment is essential.

Preferences include 2+ years of SQL experience for query writing and exposure to VB/VB.NET.

Availability for a Monday-Friday schedule (5:00 am - 3:00 pm EST) is required, with potential shifts and overtime adjustments based on client needs.