Contract Configuration Analyst

Job Description

POSITION SUMMARY

The Configuration Analyst will be responsible for supporting all aspects of system configuration ensuring that all system configurations are programmed accurately for Authorizations and Claims.

RESPONSIBILITIES-DUTIES

Configure rates based on provider contracts to ensure accurate payments of claims and capitations to providers.

Configure rates based on vendor contracts to ensure accurate payments.

Maintain system configuration based on data received from contracting

Audit accuracy of Fee schedules in test environment prior to in-loading in production

Assign Fee Set Assignments by line of business or health plan code

Program and audit Interest Payment

Program and audit RBRVS Geographical Adjustment

Apply previous experience and knowledge to research and resolve claim/encounter issues, pended claims and update system as necessary

Coordinating with internal departments to resolve and assist with system related issues/builds

Other duties may be assigned by the Supervisor of Contract Configuration or Manager of Contract Configuration.

Ability to handle fluctuating volumes of work and be able to prioritize work to meet deadlines and needs of user community.

EDUCATION & EXPERIENCE REQUIREMENTS

Minimum 5 years’ of administrative healthcare experience preferred

High School Diploma or GED, some college preferred

Experience with benefits and system configuration and interpretation

Medical terminology, CPT, Revenue codes, ICD10, RBRVS, HCPCS, HIPPS code sets

Must have experience with all lines of business, Medicare, Medi-Cal, and Commercial claims and know industry guidelines

Knowledge of software applications such as EZCAP is a plus

Must be familiar with Microsoft Office (Word, Excel, Outlook, Microsoft, Access, SQL)

Follow up on assignments, show initiative, be self-motivated, and have a strong work ethic

Possess strong time management skills, including the ability to prioritize deadlines on multiple projects.

Produce accurate and high-quality work on time and consistently.

Individual should also demonstrate the ability to work with all levels of staff within AMM

Must be highly organized and able to perform multiple tasks efficiently, be computer literate

Ability to work in a fast-paced environment

Strong analytical skills and problem solving skills are necessary

Must obtain a positive attitude and have excellent communication skills

AMM BENEFITS

When you join AMM, you’re not just getting a job—you’re getting a benefits package that puts YOU first:

Health Coverage You Can Count On: Full employer-paid HMO and the option for a flexible PPO plan.

Wellness Made Affordable: Discounted vision and dental premiums to help keep you healthy from head to toe.

Smart Spending: FSAs to manage healthcare and dependent care costs, plus a 401(k) to secure your future.

Work-Life Balance: Generous PTO, 40 hours of sick pay, and 13 paid holidays to enjoy life outside of work.

Career Development: Tuition reimbursement to support your education and growth.

Team Fun: Paid company outings and lunches because we work hard, but we also know how to have fun!

Full-time