Must have industry experience in HealthRules Payor, and must have 2 years' experience in the following skills:
1. HealthRules Configuration Experience
2. Provider Reimbursement Experience
3. Claims Payment Configuration Experience
Nice to have:
1. Training
2. Testing
Payer Claims Processing - Perform and document system configuration of Provider Contracts, Claims & Benefits into HealthEdge's HealthRules system. Responsibilities include:
1. Ensure HealthRules system business rules are compatible with other internal systems in the enterprise environment
2. Document Desk Level Procedures for HRP Configuration processes
3. Develop, document and execute test plans for configuration testing
4. Functional business experience in the health payer industry, specifically in benefits configuration, claims adjustments or appeals
5. Interpret benefit & contract specifications into the proper business rules and components for config in the system to drive system functionality
6. Support Training Material Content & Training Operations teams in HealthRules
Experience 2+ years' experience implementing or supporting HealthEdge HealthRules software, Experience with Medicare preferred
Additional Job Details:
1 - Configuration & Release Management (P3 - Advanced) |
2 - Provider Network Management (P3 - Advanced) |
3 - Health Benefits Solutions (P2 - Intermediate) |
4 - Training and Performance Support (P2 - Intermediate)
Job Type: Contract
Pay: Up to $45.00 per hour
Schedule:
- 8 hour shift
Application Question(s):
- Are you fully vaccinated?
Experience:
- HealthRules Configuration: 2 years (Preferred)
- Provider Reimbursement: 2 years (Preferred)
- Claims Payment Configuration: 2 years (Preferred)
Work Location: Remote
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