Medicare / Medi-Cal Configuration and Integration Analyst - Claims / Pricing

2 weeks ago


St Louis, United States ZEEKTEK Full time

We have 12-month contract to hire position open for an Medi-Cale/Medicare Operations Configuration and Integration Analyst position. The candidate needs to have a strong background with Medi-Cale (preferred) or Medicare, claims, pricing, provider contracts, Industry standard coding, revenue, CPT, HCPCS, ICD-10. Must have a background with claims payments and adjudication. Must have a background with Medi-Cale rates (preferred) or Medicare rates.

The position is doing systems configuration/loading for contract rates and loading the benefits.

Candidates should be in pacific time zone as this is the working hours
Day to day responsibilities:

  • Review provider contracts, configure the terms and rates within the multiple claims pricing systems used to prices provider claims.
Describe the performance expectations/metrics for this individual and their team:
  • Quality of 98% percent accuracy completed all assigned
  • projects within 15-day TAT turnaround time.
Tell me about what their first day looks like:
  • Overview of Pricing configuration teams, training on pricing applications.
What previous job titles or background work will in this role?
  • Could vary refer to skills. Configuration Analyst, provider reimbursement specialty, experienced claim examiner
Any future projected positions potentially coming up? Choose an item. If yes, note: Internal/External Groups with which the Candidate will interface: Internal-Provider Network Management, Claims, Provider Data Management Required Skills/Experience: Intermediate to Advanced Preferred Skills/ Experience: 1. Experience and prior knowledge of provider contract terms 1. Knowledge of claim payment and adjudication 2. Industry standard coding, revenue, CPT, HCPCS, ICD10 codes 2. Experience with or knowledge of Medicare and or Medi-Cal rates. 3. Experience with system configuration/loading contract rates or loading benefits 3. Works independently, quick learner, self-driven, investigative, thorough, quality focused, collaborative, participatory in team settings Education Requirement: Bachelor's Degree Education Preferred: Software Skills Required: Microsoft, Outlook, Excel Intermediate level, Power Point

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