Skip to content

System Configuration Specialist

 

Centivo is a new type of health plan that’s built to save 15% or more compared to traditional insurance carriers and is easy to use for employers and employees. Centivo’s mission is to bring lower cost, higher quality health care to the millions of people in the United States who struggle to pay their health care bills.

 

With Centivo, employers can implement a health plan administrator that provides a range of network and benefit options to best meet the needs of their diverse workforce.  We take unnecessary cost out of the healthcare system by directly negotiating competitive prices with health systems and independent practices that you know and trust, and provide employees with a plan option in which they coordinate their care through their selected primary care team in exchange for lower out-of-pocket costs. An alternative to traditional insurance carriers or third-party administrators, Centivo offers the technology, network, claims processing, customer support, and population health management to fully administer health benefits.

 

At Centivo, we never lose sight of the fact that we are dealing with healthcare, with emotions, with anxiety, with fear, and with lives. We treat members and their families with the same level of care that we would use to treat our own families.

 

Summary of this role:

The System Configuration Analyst position is responsible for the general configuration and maintenance of The Core Claims System. The successful candidate will be responsible for assisting in the ongoing configuration, management and oversight in the Core Claims system related to Benefits, Pricing, Workflow, and Vendor Integrations.

The System Configuration Analyst must have the ability to quickly identify, triage, diagnose, and resolve reported issues with the intent of improving the performance of the system for business units. Tasks and decision-making are generally independent in nature but will require collaboration with internal and external partners frequently.

Coordinates with all business units and external vendors during client implementations and/or conversions to determine requirements and assures that interfaces between internal systems and vendor interfaces meet client needs as well as operational processes.

In this position you will have the following responsibilities:

  • Perform unit and/or end user testing for new configuration, programming enhancements, new benefit designs, new provider contracts, and software changes as necessary that affect claim adjudication rules.
  • Proactively identify opportunities and recommend system solutions which increase automation, resolve inefficiencies and enhance claims processing and reporting to meet and exceed business requirements.
  • Research and resolve claim problems or issues that are configuration related in a timely and accurate manner
  • Interact and coordinate system changes and schedules as necessary with the IT Technical Analysts.
  • Act as a liaison with specified user areas to define business requirements and processes for project deployment.
  • Duties and responsibilities are not intended to be all-inclusive, they represent key elements considered necessary to successfully perform the role.

 

Qualifications:

  • Strong organizational skills and the ability to work independently, problem-solve, and make decisions.
  • Requires exemplary customer service and effective communication skills; must be able to resolve issues with internal and external customers in a professional and timely manner.
  • Ability to work in a fast-paced environment managing multiple issues with pressure of production schedules and deadlines
  • Ability to work collaboratively and influence others to drive results across multiple functional teams.
  • Must be extremely detail-oriented.

Education and Experience:

  • Bachelor’s degree or equivalency in experience and education
  • Candidates must have at least 5-7 years of experience with TPA and Self-Funding processes and at least 3 in system configuration. Ideally, candidate must have prior experience with a highly automated and integrated claim adjudication system, El Dorado-Javelina preferred but not required.
  • Comprehensive knowledge of professional and institutional claims adjudication. Coding knowledge and experience with CPT, HCPCS, ICD9, CDT, Revenue, DRG and other relevant medical and industry-standard codes.

Job application

A form that'll allow a visitor to apply for a job opening
  • Drop files here or
    Accepted file types: pdf, doc.
  • This field is for validation purposes and should be left unchanged.
Don't See What You Are Looking For?

Return to careers to view all open positions