Overview Claims Analyst, Configuration Information Management. Job Summary: Responsible for accurate and timely implementation and oversight of critical information on claims databases. Synchronizes data among operational and claims systems and applies business rules as they pertain to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as they relate to contracting, benefits, prior authorizations, fee schedules, and other business requirements. This position’s primary responsibility and focus will be related to the Texas Medicaid Directed Payment Program (DPP). Responsibilities Analyze and interpret data to determine appropriate configuration changes. Accurately interpret state and/or federal benefits, contracts, and additional business requirements and convert these terms to configuration parameters. Coordinate and facilitate coding and updates related to benefit plans, provider contracts, fee schedules, and various system tables through the user interface. Apply experience and knowledge to research and resolve claim/encounter issues, pended claims, and facilitate system updates as necessary. Work with fluctuating volumes of work and prioritize tasks to meet deadlines and the needs of the user community. Qualifications Required Education: Associate degree or equivalent combination of education and experience Required Experience: 2-5 years Preferred Education: Bachelor’s Degree or equivalent combination of education and experience Preferred Experience: 5-7 years Details Location: Houston, TX Employment type: Full-time Job function: Finance and Sales Industries: Hospitals and Health Care Seniority level: Entry level Compensation and Equal Opportunity Pay Range: $54,922 - $107,099 ANNUAL Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. #J-18808-Ljbffr Molina Healthcare
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