Site Configuration Analyst I (4977BR) Boise, Idaho

Job Summary

Responsible for performing research and analysis of claims processing workflow including anomalies/discrepancies and developing a resolution for these findings.  Addresses State client issues, inaccurate processes, tests claims, applies Federal and State guidelines and presents findings to the State client.  Considered a Subject Matter Expert on Medicaid Business processes and works closely with Business Architects and Application Development Teams presenting client and contractual requirement data.    Also responsible for maintaining and configuring the system with fee and reference updates on a regular bases.   Determines best practices and suggests how to improve current practices.  Develops recommendations to solve problems and issues related to business operations and maintains all required documentation is current and up-to-date.

Essential Functions

• Monitors, researches and analyzes recurring claims processing issues and makes resolution recommendations to correct discrepancies and/or findings.
• Meets with client, business architects and serve as a Subject Matter Expert on multiple Stored Procedures and Desktop Processes and present findings and corrective recommendations.
• Runs daily and ad hoc queries to assist other units with their daily operational needs.
• Serves as Configuration Analyst on multiple special projects performing analysis, configuration, developing test cases, scenarios, and ensuring the business processes are functioning properly to meeting requirements. 
• Develops documentation to track quality assurance of business processes and software upgrades/changes.
• Other duties, as assigned.

Knowledge/Skills/Abilities• Proficient in MS Office Suite
• Understanding of claims processing and Medicaid systems
• Analytic and critical thinking skills are required
• Ability to work independently, with minimal supervision
• Excellent verbal and written communication skills
• Ability to abide by Molina’s policies
• Ability to maintain attendance to support required quality and quantity of work
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers

Required Education: 
Associate’s Degree or equivalent experience
 
Required Experience: 
SQL queries 
1 -3 years experience in a healthcare and/or insurance claims processing environment.
Word, Excel, Powerpoint
                                                                                                   

Preferred Experience:
Knowledge of Medicaid/Medicare claims processing preferred.
1 - 2 years experience working with QNXT, preferably knowledge of version 4.6 or higher   
 
 
Molina Healthcare offers competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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