Share this Job

Go Back

Configuration Analyst Loc:Long Beach, CA Dur:6 M+

Long Beach, CA
2018-09-28 19:01:37
Job Type: Contract

Configuration Analyst

Location:Long Beach, CA

Duration:6 months

Summary: -

  • Responsible for the daily configuration maintenance within the Configuration Information Management (CIM) Operations Team.
  • Responsible for interpreting specific State and/or Federal Benefits, Contracts as well as additional business requirements and converting these terms to configuration parameters.
  • Also responsible for coding, updating and maintaining benefit plans, provider contracts, fee schedules and various system tables through the user interface.

Essential Functions: -

  • Receive information from Health Plan or Corporate for update of information in computer system(s).
  • Analyze data by applying knowledge and experience to ensure appropriate information has been provided.
  • Apply previous experience and knowledge to research and resolve claim/encounter issues, pended claims and update system(s) as necessary.
  • Analyze and interpret data to determine appropriate configuration changes.
  • Unit test simple configuration changes.
  • Maintain thorough and concise documentation for tracking of all provider, contract, benefit or reference table configuration change request forms (CCRF) for quality audit purposes.
  • Monitor claims queues to identify issues, makes recommendations, and implements configuration changes to improve claims TAT and accuracy.


  • Intermediate level of knowledge in Microsoft applications Intermediate level of knowledge in medical terminology, ICD-9, CPT and HCPC
  • Ability to work independently as well as within a team
  • Ability to articulate simple to moderate configuration solutions

Required Experience:

  • 5-7 years healthcare experience, Medicare and Medicaid a plus.
  • 5-7 years Claims Operations or application vendor experience.
  • 5-7 years experience interpreting benefits, contracts and other business requirements.
  • 5-7 years experience with medical coding initiatives and coding guidelines.

Day to day responsibilities:

  • QNXT system configuration,
  • Claims resolution review,
  • inventory claims monitoring,
  • root cause analysis of claims issues.

Required Licensure: QNXT certified Minimum years of experience: 5years QNXT configuration, 10 years healthcare or claims experience. 

Key Skills:
Medicare and Medicaid,medical coding initiatives ,QNXT configuration and certified