Configuration Analyst Resume Dayton, OH - Hire IT People

SUMMARY

Excellent organizational, analytical, research and problem solving skills
Ability to perform both independently and as a productive team member
Strong work ethic, ability to multi - task, self motivated and focused
Detail oriented, resourceful, excellent time management and communication skills
Strong interpersonal and communication skills
Understanding of the healthcare field and knowledge of Medicare, Medicaid, Marketplace
Microsoft Access, some SQL
Facets, NetWorX

PROFESSIONAL EXPERIENCE

Confidential, Dayton, OH

Configuration Analyst

Responsibilities:

Responsible for requirements definition, documentation, design, testing and implementation support using appropriate templates or analysis tool
Meet SLA requirements established by AGILE methodology
Create user stories with clearly defined acceptance criteria within TFS utilizing AGILE methodology
Attend daily standup, grooming sessions, sprint reviews, business meetings as part of AGILE methodology
Review and interpret regulatory items and medical policies, timely delivery of required updates
Assist in the configuration and implementation of new markets and products as well as existing business
Recommend improvements to existing procedures as applicable
Identify, research and resolve inaccuracies and inconsistencies in the system as they impact claims payment.
Document root cause, trends and corrective action
Run claims impact reports as applicable
Collaborate with internal customers including member benefits, pharmacy, regulatory, medical management, etc.
Document benefit or reimbursement solutions, workflow processes, testing
Document the status of open issues, the configuration design and final resolution within department guidelines
Audit configuration to ensure accuracy

Confidential, Indianapolis, IN

Senior Configuration Analyst

Responsibilities:

Define and configure benefit requirements for Medicaid products based on market needs
Work with the health plan to obtain benefit related requirements
Review, define, create and maintain all related benefit documents
Provide technical support for post implementation research and correction of benefit issues
Identify best approach to configure benefits
Create test claims and validate benefits configuration
Know the data model and apply the configuration component changes, concepts, practices and procedures as defined by Confidential