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Position: Configuration Analyst
Location: Remote
Duration: Long Term
Client: Wipro
Job Description
The Configuration Analyst is responsible for designing, configuring, testing, implementing, and maintaining HealthRules Payor pricing, claims, and benefit configuration according to business requirements. This role supports accurate and efficient claims processing, data reporting, and ongoing system maintenance.
The analyst will investigate and resolve configuration-related provider, member, and claim processing issues, assist business departments in understanding HealthRules Payor configuration, and participate in complex implementation and configuration projects. The position serves as a Subject Matter Expert (SME) for HealthRules Payor customer projects requiring claims system configuration modifications.
Responsibilities
Design, develop, configure, and test HealthRules Payor configuration, contracts, products, and policies.
Analyze, configure, test, implement, and maintain HealthRules Payor to support changes in contracts, products, legislation, policies, and procedures.
Test, implement, and provide training for new HealthRules Payor releases, modules, and third-party product updates.
Develop test scenarios and manage the timely resolution of testing defects and configuration issues.
Create and monitor post-production audit reports to validate configuration changes.
Develop and maintain configuration documentation and communicate system changes.
Work closely with Business Users, Technical Teams, and QA to create detailed functional requirements and testing scenarios.
Research and resolve provider, member, and claims-related service requests by updating HealthRules configuration.
Recommend and document new procedures to improve efficiency within HealthRules Payor and related third-party applications.
Monitor Medicare-related configuration impacts and recommend timely system updates.
Minimum Requirements
Minimum 3 years of experience in payer operations and claims processing.
Minimum 3 years of hands-on configuration experience with HealthEdge HealthRules Payor.
Working knowledge of Medicare operations, system development, and testing.
Strong analytical and problem-solving skills.
Proficiency in Microsoft Excel, Word, Access, PowerPoint, and Visio.
Experience working within a matrix organization.
Excellent written and verbal communication skills.
Preferred Qualifications
Previous experience with CMS and Medicare Operations.
Experience with ClaimXten.
Experience with Axiom TranSend.
Experience with Axiom TransShuttle.
Education
Bachelor's degree in Business, Healthcare, or a related field preferred.
Equivalent professional experience may be considered in lieu of a degree.
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