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Contract Configuration (1114149)
21281 Burbank Blvd Woodland Hills, CA 91367
Wollborg Michelson is seeking Contract Configuration Analyst for a renowned healthcare insurance company located in Woodland Hills, CA. We are interviewing Monday-Friday as the client would like to meet candidates immediately! These positions are 6 months - 1 year contract opportunities with a possibility to be temp-to-hire with excellent performance and attendance.
Find Your Dream Job
Finding a Dream Job can feel a lot like searching for a needle in a haystack. We start by viewing each candidate as an individual, identifying their distinct strengths and guiding them to the right opportunities. We' re also big believers in mentoring our candidates and creating long-term relationships. Helping you find your Dream Job is really just the start. We want to help you build a Dream Career!
Contract Configuration Analyst
Configuring into Core Reimbursement System
Position Purpose: The Operations Configuration and Integration Analyst creates, updates, tests and maintains system configuration tables and files to support accurate claims adjudication in a multiple product, multiple state, managed care environment.
- Configure contracted provider contracts into claims system to determine appropriate amounts for adjudication.
- Maintain and update provider databases to include key provider demographics and specialty provider information
- Audit provider insurance policies to confirm compliance with contract requirements
- Load contracted rates into claims system
- Knowledge of CPT/ICD 9-10
- Must be detail oriented
- Review contracts and assign pay classes and applicable provider information based on contract language. If configuration is needed to accommodate a contract, notify the appropriate parties.
- Assist with the internal communication of all new and revised material contract terms and provisions to all affected departments
- Review new and current provider contracts and established state guidelines
- Participate in determining the appropriate configuration of the claims payment process in the appropriate subsystem of the claims payment information system in conjunction with health plan, claims and corporate management and information systems staff
- Troubleshoot and problem solve contract implementation issues related to basic system configuration
Education/Experience: Bachelor’ s Degree or an equivalent combination of education and experience in a managed care environment. Minimum one to two years experience in an automated medical claims environment and managed care/multiple product environment desired. Minimum one to two years experience in systems logic and testing desired.
Senior Program Manager
Jessica obtained her Bachelor’s Degree in Biological Sciences from California State University, Sacramento and a Master’s Degree in Forensic Science from National University. She began her career in Post-Secondary Education, providing Career Counseling and Workforce Training to graduates. Jessica has over 8 years of business development and recruitment experience. She has worked in Staffing & Career Services providing workforce development and strategic staffing support to small, medium and large companies.
In addition to her professional pursuits, Jessica often indulges in her love for travel and travels throughout the country conducting motivational talks & presentations to small and large groups on a variety of topics.