Curative HR LLC
System Configuration Lead
Curative HR LLC, Austin, Texas, us, 78716
The System Configuration Lead plays a critical role in ensuring that our claims systems are functioning optimal efficiency and accuracy. This role will be responsible for understanding Curative's business operations across products, plans, group setup, benefits, and provider contracting and setup and translating those needs into system configuration. This role will lead a team of system configuration analysts.
Our team is remote, and we're dedicated to creating an ambitious and diverse organization to represent and support the patients we serve.
Finally it's important to us that everyone on our team be prepared to work with and supportive of a variety of backgrounds, roles, and needs. Our organization is built on trust and mutual respect, we know that it's only together that we achieve truly great things.
Responsibilities
Solicit and analyze business requirements as they relate to system configuration supporting product, benefit plan, group/account, provider contract, or other functionality within the core claims system Document configuration design decisions Lead the team in implementing and testing configuration within the claims system to meet business requirements Participate in prioritization activities with configuration team and business leaders within the organization Support the business with troubleshooting of claims system issues and recommend corrections where necessary Develop and manage goals for the team to improve efficiency and accuracy of claims processing Develop and improve upon processes for managing configuration requirements, workflows, and processes Please reach out if this describes your experience
7+ years of working within a healthcare payer environment in Operations or Technology 5+ years of experience working hands-on with HealthRules Payer required Deep knowledge of healthcare claims processing including adjudication, pricing, benefit management, and provider contracting, and pricing methodologies (Medicare Professional, IPPS/OPPS methodologies, etc.) Additional experience working with other claims platforms (QNXT, Facets, etc.) is a plus Working knowledge of HIPAA EDI transactions (837, 835) Demonstrated expertise with common tools such as MS Word, MS Excel Knowledge of Robotic Processing Automation (RPA) tools in a healthcare payer environment is a plus
Our team is remote, and we're dedicated to creating an ambitious and diverse organization to represent and support the patients we serve.
Finally it's important to us that everyone on our team be prepared to work with and supportive of a variety of backgrounds, roles, and needs. Our organization is built on trust and mutual respect, we know that it's only together that we achieve truly great things.
Responsibilities
Solicit and analyze business requirements as they relate to system configuration supporting product, benefit plan, group/account, provider contract, or other functionality within the core claims system Document configuration design decisions Lead the team in implementing and testing configuration within the claims system to meet business requirements Participate in prioritization activities with configuration team and business leaders within the organization Support the business with troubleshooting of claims system issues and recommend corrections where necessary Develop and manage goals for the team to improve efficiency and accuracy of claims processing Develop and improve upon processes for managing configuration requirements, workflows, and processes Please reach out if this describes your experience
7+ years of working within a healthcare payer environment in Operations or Technology 5+ years of experience working hands-on with HealthRules Payer required Deep knowledge of healthcare claims processing including adjudication, pricing, benefit management, and provider contracting, and pricing methodologies (Medicare Professional, IPPS/OPPS methodologies, etc.) Additional experience working with other claims platforms (QNXT, Facets, etc.) is a plus Working knowledge of HIPAA EDI transactions (837, 835) Demonstrated expertise with common tools such as MS Word, MS Excel Knowledge of Robotic Processing Automation (RPA) tools in a healthcare payer environment is a plus