Team Lead Configuration (Pricing NV MP)

Job Summary: The Team Lead, Configuration is responsible for day-to-day activities surrounding the knowledge and insight around development and support of medical benefits, provider reimbursement, letters, and clinical editing. Essential Functions: Responsible for day-to-day activities surrounding the knowledge and insight around development and support of medical benefits, provider reimbursement, letters, and clinical editing Guide and direct successful completion of daily tasks. Responsible for onboarding, training and development of staff Prioritize all work, requests and activities. Escalate any area of significant resource contention along with recommendation for resolution Track issues and status to ensure proper follow-up, coordination with business area and provide solutions Update project that configuration is involved with and coordinate any needed changes with manager Provide management with ticket dashboards. Identify root cause of issues and appropriate pro-active resolution to reduce tickets in the future Ensure ticket controls, communication and approvals are followed prior to system implementation Maintain and support fee schedules and methodology is consistent with required standards Provide oversight to vendor management tasks conducted by team members. Ensure timely responses and resolution Assist in auditing system configuration to ensure accuracy and internal controls are in place to minimize potential fraud and abuse and any business issues Perform any other job duties as requested Education and Experience: Associates Degree or equivalent years of relevant work experience is required Minimum of three (3) years of health plan business or systems solutions experience is required Exposure to Facets or equivalent system is preferred Prior supervisory experience is preferred Competencies, Knowledge and Skills: Advanced computer skills and abilities in Facets or similar processing systems Medical terminology Advanced proficiency in Microsoft Suite to include Word, Excel and Access High level of programming and systems development knowledge Effective identification of business problems, assessment of proposed solutions to those problems, and understanding of the needs of business partners Demonstrated ability to successfully define a portfolio of initiatives including business requirements gathering, definition/prioritization, project scope definition, project staffing requirements, application configuration, testing approach, training, documentation, reporting strategy, and change management process Knowledge of regulatory reporting and compliance requirements Excellent listening and critical thinking skills Effective problem solving skills with attention to detail Excellent written and verbal communication skills Ability to work independently and within a team environment Strong interpersonal skills and high level of professionalism Ability to develop, prioritize and accomplish goals Proper medical coding knowledge and claims processing skills Licensure and Certification: Certified Professional Coder (CPC) is preferred Working Conditions: General office environment; may be required to sit or stand for extended periods of time Compensation Range: $81,400.00 - $130,200.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-GB1 The CareSource mission is known as our heartbeat. Just as we support our members to be the best version of themselves, our employees are driven by our mission to create a better world for members, stakeholders and providers. We are difference-makers who combine compassionate hearts with our unique business expertise to make every opportunity count. Each claim, each phone call, each consumer-centric decision is a chance to change the world for one member, and our employees look for ways to do that every day. The challenge is, there is no one right way to be the difference and we’re looking for people like you that will rewrite that definition every day. We do what it takes to form creative solutions that make our community and the world just a little better. Discover what it means to be #UniquelyCareSource.

Salary : $81,400 - $130,200