Contract Configuration Analyst I

Position Summary

The Configuration Analyst I will be responsible for supporting all aspects of system configuration ensuring that all system configurations are programmed accurately for Authorizations and Claims.

Responsibilities

• Configure rates based on provider contracts to ensure accurate payments of claims and capitations to providers.
• Configure rates based on vendor contracts to ensure accurate payments.
• Maintain system configuration based on data received from contracting.
• Audit accuracy of Fee schedules in test environment prior to in-loading in production.
• Assign Fee Set Assignments by line of business or health plan code.
• Program and audit Interest Payment Program and audit RBRVS Geographical Adjustment.
• Apply previous experience and knowledge to research and resolve claim/encounter issues, pended claims and update system as necessary.
• Coordinate with internal departments to resolve and assist with system related issues/builds.
• Handle fluctuating volumes of work and prioritize work to meet deadlines and needs of user community.

Requirements

• Minimum 5 years’ of administrative healthcare experience preferred.
• High School Diploma or GED, some college preferred.
• Experience with benefits and system configuration and interpretation.
• Medical terminology, CPT, Revenue codes, ICD10, RBRVS, HCPCS, HIPPS code sets.
• Experience with all lines of business, Medicare, Medi-Cal, and Commercial claims and know industry guidelines.
• Knowledge of software applications such as EZCAP is a plus.
• Familiarity with Microsoft Office (Word, Excel, Outlook).
• Ability to follow up on assignments, show initiative, be self-motivated, and have a strong work ethic.
• Strong time management skills, including the ability to prioritize deadlines on multiple projects.
• Produce accurate and high-quality work on time and consistently.
• Demonstrate the ability to work with all levels of staff within AMM.
• Be highly organized and able to perform multiple tasks efficiently, be computer literate.
• Have strong analytical skills and problem-solving skills.
• Obtain a positive attitude and have excellent communication skills.

Qualifications

• Must have experience with all lines of business, Medicare, Medi-Cal, and Commercial claims and know industry guidelines.
• Must be familiar with medical terminology, CPT, Revenue codes, ICD10, RBRVS, HCPCS, HIPPS code sets.
• Must have experience with software applications such as EZCAP.
• Must be familiar with Microsoft Office (Word, Excel, Outlook).

Skills

• Ability to handle fluctuating volumes of work and be able to prioritize work to meet deadlines and needs of user community.
• Experience with benefits and system configuration and interpretation.
• Knowledge of medical terminology, CPT, Revenue codes, ICD10, RBRVS, HCPCS, HIPPS code sets.
• Experience with software applications such as EZCAP.
• Familiarity with Microsoft Office (Word, Excel, Outlook).

Benefits

When you join AMM, you’re not just getting a job—you’re getting a benefits package that puts YOU first:

• Health Coverage You Can Count On: Full employer-paid HMO and the option for a flexible PPO plan.
• Wellness Made Affordable: Discounted vision and dental premiums to help keep you healthy from head to toe.
• Smart Spending: FSAs to manage healthcare and dependent care costs, plus a 401(k) to secure your future.
• Work-Life Balance: Generous PTO, 40 hours of sick pay, and 13 paid holidays to enjoy life outside of work.
• Career Development: Tuition reimbursement to support your education and growth.
• Team Fun: Paid company outings and lunches because we work hard, but we also know how to have fun!