Analyst I
2 weeks ago
**What you can expect**
Find joy in serving others with IEHP We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an **authentic experience**
Under the direction of the Supervisor of Provider Data Configuration, the Analyst is responsible for managing the front-end maintenance of Provider records within the Business System. The primary functions of this position include but are not limited to, accurate interpretation of contractual and claim related provider information, systematic review, and setup of provider data to be in line with business requirements, and in-depth root cause analysis for provider configuration related issues that arise from claims and integrated systems errors.
**Perks**
IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.
- CalPERS retirement
- 457(b) option with a contribution match
- Generous paid time off
- vacation, holidays, sick
- State of the art fitness center on-site
- Medical Insurance with Dental and Vision
- Paid life insurance for employees with additional options
- Short-term, and long-term disability options
- Pet care insurance
- Flexible Spending Account - Health Care/Childcare
- Wellness programs that promote a healthy work-life balance
- Career advancement opportunities and professional development
- Competitive salary with annual merit increase
- Team bonus opportunities
**Education & Experience**
- Two (2) years of experience in Business Systems Configuration or Managed Care Operations or Contracting in Healthcare experience required
- Bachelor’s Degree in Business Administration, Health Care Administration, Computer Information Systems (CIS), Management Information Systems (MIS), or other related field from an accredited institution required
- In lieu of the required degree, a minimum of four (4) years of additional relevant work experience is required for this position: two (2) years of Health Care or Managed Care Operations experience is required and two (2) years of claims auditing or Provider Contracting required
**Key Qualifications**
- Knowledge of Medicare and Medi-Cal fee schedules and benefit structure, and regulatory billing guidelines preferred. Knowledge of CMS, DHCS, DMHC, NCQA rules and regulations preferred
- Extensive knowledge of CPT, HCPCS, Revenue, ICD10 coding rules and guidelines a plus
- Familiar with basic medical claims processing
- Experience in major managed care system migration/implementation preferred.
- Basic knowledge of general managed care operations required; delegated plan model preferred
- Basic knowledge of relational database structure
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