Johns Hopkins Medicine Systems Configuration Analyst II, Pricing in Glen Burnie, Maryland
Systems Configuration Analyst II, Pricing
Johns Hopkins Health Care,
Glen Burnie, MD
Requisition # 156060
Full Time (40 hours)
Weekend Work Not Required
Johns Hopkins Health System employs more than 20,000 people annually. Upon joining Johns Hopkins Health System, you become part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. If you share in our vision, mission and values and also have exceptional customer service and technical skills, we invite you to join those who are leaders and innovators in the healthcare field.
The Systems Configuration Analyst II, Benefits, reports to the Manager, Business Support and is responsible for updating, testing and ensuring proper loading of benefit adjudication rules, benefit categories and systems maintenance of MC400. In addition, the incumbent will identify and troubleshoot issues associated with the Schedule of Benefits, the Summary Plan Document and the MC400 system setup. Provider Contract and fee schedules as well as systems adjudication logic within the provider pricing structure should be reviewed to ensure claims are paid in accordance with the provider agreement and client account benefit structure. The Systems Configuration Analyst II, Benefits, will assist the Claims Database Administrator and the Manager, Business Support with the development and implementation of processes that improve current business flow and create efficiencies within the end product delivery. The Systems Configuration Analyst II, Benefits, will also interface with Claims staff to setup and schedule required testing of benefit adjudication rules and ad-hoc changes to benefit setups in MC400 as well as the Systems Configuration Analyst II, Pricing for fee pricing schedules.
Requires a Bachelor's Degree in Business, HealthCare Management or related discipline or Associates Degree with 5 years equivalent industry experience, specifically claims processing and systems.
Requires a minimum of 5 years experience in the healthcare industry including 3 years in an on-line adjudication claims system within a managed care environment.
Included in the 5 years, a minimum of 2 years experience in system updating and testing with CPT/HCPSC/ICD9 coding, fee schedules and benefits plans is preferred.
MC400 TEST and Production environment system experience is strongly preferred.
Johns Hopkins Health System and its affiliates are Equal Opportunity/Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity, sex, age, national origin, disability, protected veteran status, and or any other status protected by federal, state, or local law.