claims configuration analyst

2 weeks ago

Florida, United States Integrated HomeCare Services Full time

Who we are:

IHCS provides an Integrated Delivery System in the home setting, which includes, DME, Respiratory, Home Health and Home Infusion services. IHCS has a select network of Medicare and/or Medicaid Certified and Accredited providers to respond to the needs of our patients – 24/7. We operate with the sole intent of providing the highest quality in-home care services that improve and enhance the daily living for our patients, where our patients are #1

Our delivery model is trusted by national Managed Care Organizations (MCOs), physicians and patients, positioned with over two decades of expertise as the market leader in value-based Home Health, Durable Medical Equipment, and Home Infusion Services. We currently serve over 2 million lives throughout the nation and the Commonwealth of Puerto Rico.

Join our team as we strive for excellence through teamwork delivering high quality care to our patients through Exceptional Customer Service, Proven Outcomes, and Seamless Care.

Full time team members competitive compensation package, include but not limited to;

  • Medical, Vision, Dental, Short- and Long-term insurance
  • Paid Federal Holidays
  • Inclusive rich sick and vacation paid days
  • Employer paid life insurance
  • 401K with employer contribution
  • Wellness program with reward incentives
  • Employee recognition and reward programs
  • Comprehensive paid training program

What will you be doing:

As a Claims Configuration Analyst you will configure system to health plan and provider contracts in addition to create user desk level procedures regarding Health Rule Payor (HRP). Develop, document and execute test plans for configuration testing. The incumbent will also serve in member benefits and products, provider contracts, claims editing, reference data and their enhancements including claims configuration improvements, compliance and system enhancements.

What will you come with:

  • Minimum of 2-3 years of HealthRules claim processing experience in a fast paced managed care organization
  • Minimum of 1-2 years health plan configuration experience
  • Strong knowledge of CPT/HCPCS, ICD-10,CPT4 and ICD9
  • Proficiency with Health plan benefits and provider configuration IE; HealthEdge, HealthRules Software, HealthRules Configuration, Health Plan Claims Configuration
  • Medical Biller/Coder certification a plus
  • HealthRules Configuration Experience, Provider Reimbursement Experience, Claims Payment Configuration Experience

Join our team as we strive for excellence through teamwork, where our patients are #1

IHCS is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Experience

Required

  • 1 year(s): HealthRule Payor
  • 2 year(s): Comprehensive knowledge of Managed Care industry and products.
  • 3 year(s): Medical Terminology and Medical Coding
  • 1 - 2 years: Health Plan/Billing configuration experience proficient

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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