Your Role

The Pricing Analytics and Contract Configuration team is responsible for configuring systems to pay per negotiated provider contracts. The Configuration Analyst, Associate will report to the Pricing Analytics Contract Configuration Manager. In this role you will conduct build activity, run test claims to ensure future claims will be paying correctly based on the contractual terms. Validate that the negotiated provider contracts were built correctly and according to the contract's specification Support process improvements by identifying possible gaps and addressing remediations.

Your Work

In this role, you will:

• Analyze contract language to translate into specific pricing configuration with guidance
• Develop simple configuration approaches to support solution selection and develop documentation outlining the approach using appropriate documentation protocols
• Be accountable for the at least one contract type of configuration and testing of the assigned contracts
• Develop and execute claims tests to support the testing terms and services for in the negotiated contracts
• Work directly with Provider Contracting partners for clarifications when contract language may be unclear.
• Analyze the provider contracts to ensure accuracy in the way it was built
• Service (internal customers) with an oriented/philosophy and work in a diverse, demanding and evolving environment where strong analytical, problem-solving skills, time management and organizational skills are required
• Other duties as assigned

Your Knowledge and Experience

• Requires a bachelor's degree or equivalent experience
• 0-2 years of prior relevant experience
• Requires strong Claim's knowledge and experience
• Knowledge of FACETS, CLMS, MS Office Suite
• Previous auditing experience and claims processing experience in a health plan
• Service (internal customers) oriented/philosophy in a diverse, demanding and evolving environment with good analytical and problem-solving skills, time management and organizational skills
• Excellent interpersonal skills and ability to act as a team player

Pay Range:

The pay range for this role is: $ 25.56 to $ 35.78 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

About the Company:
Blue Shield of California