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Analyst, Configuration Information Management- Healthplan Ops (Remote in GA at Molina Talent Acquisition

, , Gabon -

Full Time

Start Date

Immediate

Expiry Date

19 Dec, 25

Salary

0.0

Posted On

20 Sep, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Data Analysis, Configuration Management, Claims Processing, Business Rules, Coding, Updating, Maintaining, Research, Problem Solving, Prioritization, Contract Interpretation, Benefit Plans, Provider Contracts, Fee Schedules, System Tables, Data Validation

Industry

Hospitals and Health Care

Description

JOB DESCRIPTION ****Candidates must reside in Georgia ***** Job Summary Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements. KNOWLEDGE/SKILLS/ABILITIES Analyze and interpret data to determine appropriate configuration changes. Accurately interprets specific state and/or federal benefits, contracts as well as additional business requirements and converting these terms to configuration parameters. Handles coding, updating and maintaining benefit plans, provider contracts, fee schedules and various system tables through the user interface. Apply previous experience and knowledge to research and resolve claim/encounter issues, pended claims and update system(s) as necessary. Works with fluctuating volumes of work and is able to prioritize work to meet deadlines and needs of user community. JOB QUALIFICATIONS Required Education Associate degree or equivalent combination of education and experience Required Experience 2-5 years Preferred Education Bachelor's Degree or equivalent combination of education and experience Preferred Experience 5-7 years To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Responsibilities

Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Validate data to be housed on databases and ensure adherence to business and system requirements.