- Develop and implement configuration in the Cognizant/Trizetto Facets system, emphasizing FACETS configuration and billing expertise.
- Support routine enrollment from a group setup and configuration perspective for all product lines.
- Support routine billing runs, ensuring accuracy and efficiency in billing processes assist in billing error research.
- Analyze inbound requests, incorporating an in-depth understanding of plans and benefits, before implementing the appropriate configuration. Where appropriate work with Sales and other stakeholder groups.
- Collaborate with cross-functional teams to comprehend business requirements, ensuring transparent communication across departments.
- Ensure the correct cadence of processes is followed, leading to accurate group and customer enrollment, billing, and claims processing.
- Perform root cause analysis for issues related to group setup, billing discrepancies, and enrollment challenges, fully mitigating issues to prevent replication.
- Create and maintain pre- and post-validation reports/queries to proactively discover group setup and billing issues, iterating processes for issue identification.
- Review system enhancements and industry trends, incorporating FACETS best practices for continuous improvement.
- Develop and maintain accurate process and policy documents related to group configuration, enrollment, and billing.
- Participate in the development and implementation of strategies for corporate and departmental projects.
- Prepare detailed analyses and reports for internal customers, emphasizing billing data and trends.
- Maintain detailed documentation related to work assignments to support audit processes.
- Utilize relational databases used to facilitate configuration, enrollment, billing implementation, and testing.
- Assist with test plan creation, test case scenarios, and detailed test scripts, emphasizing quality assurance.
- Identify and communicate configuration defects.
- Represent the department on committees and project teams.
- Perform other duties as assigned.
- Exceptional critical thinking and problem-solving skills.
- Ability to manage multiple assignments with a high level of autonomy and independence.
- Demonstrated skills in Microsoft Excel and relational databases.
- Strong analytical ability.
- Excellent organizational and communication skills.
- Strong elements of quality assurance testing expertise.
- Configuration experience, especially in FACETS configuration or billing.
- In-depth understanding of healthcare plans, benefits, and enrollment processes.
- Prior Experience working with Microsoft Dynamics, JIRA, DevOps or other work tracking/queueing tools
- Considerable paid time away from work including PTO (Paid Time Off), s ick t ime, service t ime o ff, p aid h olidays, and f loating h olidays , allowing you to take time off when it suits you best.
- Competitive 401(k) employer matching and profit-sharing program to help you save for your retirement.
- Low premium health benefits including medical, dental, and vision coverage to support your well-being and that of your family.
- Life insurance and disability coverage to ensure financial security for you and your dependents.
- An array of optional benefit plans such as accident insurance and specified disease coverage to protect you from the unexpected.
- Full tuition reimbursement (up to the IRS limit) for approved courses and programs that support continuous learning.
- A best-in-class employee Well-Being program to support all dimensions of your health and wellness.
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Professional, Group Configuration and Billing Analyst - Rochester, NY, United States - MVP Health Care, Inc.
Description
Professional, Group Configuration and Billing AnalystBurlington Office, 62 Merchants Row, Williston, Vermont, United States of America
• Headquarters Office, 625 State Street, Schenectady, New York, United States of America
• Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America
• Virtual Req #1874
Tuesday, April 30, 2024
Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it's time to make a healthy career move to MVP
Full-Time, Exempt
The Professional, Group Configuration and Billing Analyst is a key contributor responsible for configuring and maintaining the Cognizant/Trizetto Facets system. This role is integral to ensuring accurate and efficient group enrollment and billing processes, with a particular focus on strong elements of quality assurance and testing. The position demands a unique blend of technical proficiency, critical thinking, and robust communication skills to support routine group configuration, billing runs, analyze data, and ensure the proper configuration of plans to network sets to groups. This critical role supports seamless benefit administration and streamlined claims processing.
Responsibilities:
Minimum Education:
Bachelor of Science in Computer Science, Healthcare Administration, Business Management, or a related field. Equivalent experience in a healthcare organization is also accepted.
Minimum Experience:
Experience in utilizing query tools to extract data from relational databases i.e. SQL or advanced Access. Expertise in the maintenance of mapping tables to drive group setup and configuration. A strong focus on FACETS billing expertise preferred.
Required Skills:
Preferred Skills:
About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve.
At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. Specific employment offers and associated compensation will be made individually based on several factors , including but not limited to geographic location ; relevant experience, education, and training; and the nature of and demand for the role.
In addition, we offer a comprehensive benefits package that includes:
MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at
Please apply and learn more - including how you may become a proud member of our team.
