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Dahl Consulting
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Senior Configurations Analyst
Posted: 01/06/2025
2025-01-06
2025-02-19
Employment Type:
Contract
Category: Information Technology
Job Number: 27475
Job Description
Seeking a new opportunity in IT? Dahl Consulting is currently partnering with a leader in the healthcare industry. We work one-on-one with great candidates to help connect them with local employment opportunities. This company is hiring a Senior Configurations Analyst for a contract position! Interested? Get more details below.
Take the first step on your new career path! To submit yourself for consideration for this role, simply click the apply button and complete our mobile-friendly online application. Once we’ve reviewed your application details, a recruiter will reach out to you with next steps! For questions or more information about this role, please call our office at (651) 772-9225.
As an equal opportunity employer, Dahl Consulting welcomes candidates of all backgrounds and experiences to apply. If this position sounds like the right opportunity for you, we encourage you to take the next step and connect with us. We look forward to meeting you!
Dahl Consulting is proud to offer a comprehensive benefits package to eligible employees that will allow you to choose the best coverage to meet your family’s needs. For details, please review the DAHL Benefits Summary:  https://www.dahlconsulting.com/benefits-w2fta/Â
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- Contract Duration:Â 6-12 months with possible extension
- Worksite Location:Â Remote
- Compensation:Â $65.00-$100.00 per hour
- Implement CMS and regulatory business changes, ensuring compliance with State and Federal CMS and Medicare Advantage regulations
- Conduct system testing and validation for claims, benefit designs, provider contracts, and software updates affecting claims adjudication and service functionality
- Identify, triage, and resolve system issues to improve performance and collaborate with internal and external partners
- Analyze and validate new and existing configurations within the Core Claim System and ancillary systems
- Recommend Core Claim System enhancements to increase automation, address deficiencies, and improve claims processing and reporting
- Act as a liaison to define business requirements, provide training, and support project deployment
- Facilitate fee schedule setup to ensure accurate provider payments
- Coordinate with software vendors on claims system issues and resolve discrepancies
- Collaborate with stakeholders to document customer needs and provide solutions to internal and external issues
- Research and resolve configuration gaps, audit benefit plans and fee schedules, and ensure compliance with contract requirements
- Develop and deliver training and communication on system capabilities and limitations
- Conduct regular reviews of code sets (CPT, HCPCS, Revenue, etc.) to ensure compliance with medical policies and benefit configurations
- Assist in setting up code sets and pre-authorization guidelines for accurate claims processing
- Perform root-cause analysis on configuration issues and present business impact findings
- Monitor system functionality, recommending configuration changes to maintain automation and accuracy
- Create and execute test scripts, including regression testing, to validate claims configurations
- High school diploma/GED required; Associate’s or Bachelor’s degree preferred OR 5+ years of experience in complex system design and medical coding
- Knowledge of project work with the ability to meet deadlines, understand requirements, and support business deliverables
- Must possess claims processing knowledge, knowledge of benefit/claims configuration for claims and enrollment systems, as well as knowledge of audit processes and system controls
- Experience in developing training and communication plans
- Must Possess the required level of skills and abilities to read, write, speak, and apply mathematical concepts and sound reasoning
- Must be able to perform basic operations on a personal computer within the Windows operating system
- Ability to think critically and multi-task
- Required to frequently stand, use hands/arms, stoop, kneel, crouch, and occasionally sit and climb or balance
Take the first step on your new career path! To submit yourself for consideration for this role, simply click the apply button and complete our mobile-friendly online application. Once we’ve reviewed your application details, a recruiter will reach out to you with next steps! For questions or more information about this role, please call our office at (651) 772-9225.
As an equal opportunity employer, Dahl Consulting welcomes candidates of all backgrounds and experiences to apply. If this position sounds like the right opportunity for you, we encourage you to take the next step and connect with us. We look forward to meeting you!
Dahl Consulting is proud to offer a comprehensive benefits package to eligible employees that will allow you to choose the best coverage to meet your family’s needs. For details, please review the DAHL Benefits Summary:  https://www.dahlconsulting.com/benefits-w2fta/Â
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