Configuration Analyst (Claims)

Immediate Fulltime/Direct hire with our client, who is responsible for a health insurance plans provided to their Union Membership nationwide. They are seeking a Configuration Analyst support specialist with hands-on configuration experience including of a claims systems (open to any systems). Our client is setting up a new claims system (ClaimsXten) and is seeking a technical and analytical Configuration Analyst to set up the claims system. The selected candidate will join our clients Applications Development Department and will be responsible for supporting and enhancing the code auditing application to include the maintenance of codes, knowledge-bases, rules and all other appropriate updates. Primary Accountabilities Include:

- Review, analyze and recommend coding approaches to minimize denials and pends but to ensure accurate payment for the provider.
- Build, maintain and/or enhance code sets and knowledge bases.
- Investigate requests by business customers for new and\or changes to existing system setup as well as conduct testing of code, rule and knowledgebase changes and enhancements.
- Coordinate with Applications Development and Support manager and/or Team Lead, Applications Development to assure priority of new work (Governance).
- Development or enhancements of reports to quantify the savings of the auditing.
- Coordinate with the testing team for acceptance testing of changes and enhancements.
- Other duties as assigned.

Our client is located in the Glen Burnie MD area and working within a hybrid remote/onsite working setting. Are you interested in learning more? If so, contact Elite Technical right away!

Required Skills

(1) 5+ years working within a Claims processing system from an operational and systems point of view (open to any claims system)
(2) 5+ years healthcare claims payment solutions
(3) Hands-on Configuration of including; coding, working in the Wizard\Voyager (preferred) setting up user defined edits (UDEs), fees schedules, benefits, and working with Policy Admin Module (PAM).
(4) Knowledge of QNXT claims processing system is preferred, not mandatory. The tool is integrated with QNXT
(5) CPC or CCA Certifications preferred
(6) B.S. degree preferred, but direct experience may be substituted.
(7) McKesson ClaimsXten (formally ClaimCheck) BIG PLUS

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Glen Burnie, MD



Anticipated Start Date

Monday, May 30, 2022

Job Type

Direct Hire

Anticipated Duration

Direct Placement

Date Posted

Monday, April 18, 2022

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Elite Technical Services, Inc. participates in the E-Verify program to confirm the employment eligibility of all persons hired. This means that we will provide the Social Security Administration (SSA) and, if necessary, the Department of Homeland Security (DHS), with information from each new employee's Form I-9 to confirm work authorization. Elite Technical Services, Inc. will not use E-Verify to pre-screen job applicants.

Elite Technical Services, Inc. is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.