Configuration Analyst I - Provider

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PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.

Participate in the identification and implementation of solutions, which results in efficient, accurate, and quality configuration, and maintenance of Facets. Ensure timely configuration and implementation of selected solutions as directed by your trainer or mentor within your FBS team. Accountable for complying with all laws and regulations that are associated with assigned duties and responsibilities.

Essential Responsibilities :

• Assist with design of new configuration to support business needs and functionality.
• Accurately update, implement and test configuration changes as assigned by trainer.
• Assist with analyzing business requirements, test plans, training materials and procedure documents.
• Assist with executing test plans and test case scenarios to ensure requirements are being met.
• Participate in development of detail design and system walk through with respective teams to verify design and solution meet business and system requirements.
• Assist and work with business areas for the review of all reported system defects.
• Monitor, research, and resolve provider or pricing related ServiceNow tickets designated for a Configuration Analyst I. These include adding new provider types, specialties, IPA's, terminating agreement ID's, running basic queries and others as assigned by trainer.
• Assist with diagnosing and resolving system configuration problems. Begin to understand troubleshooting techniques and methods at a fundamental level.
• Responsible for quality assurance tasks. Double check your work to ensure accuracy.
• Develop an understanding of Facets Batch Logs, with the ability to troubleshoot issues as needed
• Process, troubleshoot and resolve claims in the FBS Provider claims queue in a timely manner to satisfy turnaround time requirements.
• Configure the standard provider agreements in NetworX. Assist in loading fee schedules as needed.
• Maintain Modeler database as needed.
• Support in special projects as assigned.

Supporting Responsibilities :

SUCCESS PROFILE

Work Experience : Minimum two years of relevant experience in health plan environments with at least one year experience with benefit plan administration required. Experience working with Facets is preferred.

Education, Certificates, Licenses : Associates Degree or equivalent combination of work experience and education required. BA / BS degree or ICD-10, CPT, HCPC coding knowledge preferred.

Knowledge : Extensive knowledge of industry standards and internal PacificSource, PacificSource Medicare, policy and processes. Proficiency in Microsoft systems Outlook, Excel and Word. Experience in database systems of Access and / or SQL also preferred. Strong analytical and problem solving skills. Excellent interpersonal skills including verbal and written communication. Ability to work collaboratively as a team with little supervision.

Competencies :

Building Customer Loyalty

Building Strategic Work Relationships

Contributing to Team Success

Planning and Organizing

Continuous Improvement

Adaptability

Building Trust

Work Standards

Environment : Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.

Skills :

Accountability, Collaboration, Communication (written / verbal), Flexibility, Listening (active), Organizational skills / Planning and Organization, Problem Solving, Teamwork

Compensation Disclaimer

The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range.

Base Range :

$51,393.26 - $82,229.23

Our Values

We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business :

Physical Requirements : Stoop and bend. Sit and / or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

Disclaimer : This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.