Configuration Specialist - Central Ave

Job Summary

This position assists the Director, RCM and other Configuration Specialists in correctly configuring the company practice management system (NextGen) in context of medical policies, reimbursement policies, clinical editing policies, regulatory requirements and contract details to ensure appropriate billing, payment/encounter posting, and reporting of all claims processing activities.

About the Role

Develop and maintain an understanding of current payer and NextGen configuration rules, contracts, and policies. Assists in the accurate and timely loading of the following (including annual updates): Payor contracts, Providers Fee schedules, Code set mapping. Specialized rules and alerts in Nextgen EPM.

Responsibilities

• Develop and maintain configuration documentation and communicate configuration processes, changes and best practices.
• Aids in the development and execution of test scenarios for configuration changes.
• Aids in the maintenance of system flags and understands the impact of the system flags on the claims and EHR system.
• Develops and monitors post-production audit reports to ensure the intent of NexGen EPM configuration related change and/or project requirements are met.
• Analyzes ad-hoc reports.
• Maintains department production and quality standards.
• Prepares and delivers reports and recommendations on claims payable accuracy and timeliness and related configuration opportunities to enhance revenue cycle department performance.
• Affords assistance in the implementation of high-level quality and performance management initiatives.
• Ensures outstanding customer service to all external and internal customers.
• Develops and maintains effective relationships through effective and timely communication.
• Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner.
• Documents approved software changes, updates, patches and notification of software releases including the tracking of action items and capturing software changes.
• Maintains all applicable configuration baseline documentation.
• Participates in code reviews, fixes any defects, and performance problems discovered in testing; and participates in transitions of the application components to the testers.
• Coordinates and assists the Director of Revenue Cycle Management in outside vendor audit compilation and tracking.
• Uses sound judgment to determine when to escalate issues and to whom to ensure the highest quality resolution.

Qualifications

• Bachelor's degree in Healthcare Informatics, Computer Science, or a related field.
• At least 2 years of experience in healthcare IT, preferably in revenue cycle management or practice management systems.
• Strong knowledge of NextGen configuration and payer rules.
• Experience with healthcare coding and billing regulations.
• Excellent analytical and problem-solving skills.
• Ability to work independently and manage multiple tasks simultaneously.
• Proficiency in Microsoft Office Suite, particularly Excel and Word.
• Knowledge of healthcare industry trends and best practices.

Benefits

• Multiple medical plans - including a no premium plan for employees and their families.
• Multiple dental plans - including orthodontia.
• Financial well-being - 401(k) with a company match, interest free medical line of credit, financial education, planning, and support.
• 4 Weeks of paid time off in the first year.
• Wellness program.
• Pet Insurance.
• Group life and disability insurance.
• Employee Assistance Program for the Whole Family.
• Personal and family mental and physical health access.
• Professional growth & development - including scholarships, clinical supervision, and CEUs.
• Tuition discounts with GCU and The University of Phoenix.
• Working Advantage - Employee perks and discounts.
• Gym memberships.
• Car rentals.
• Flights, hotels, movies and more.

Schedule

Full-time, Monday through Friday.

Pay

Competitive salary commensurate with experience.