[Hiring] Configuration Coordinator @Medica

Role Description

Medica's Configuration Coordinator is responsible for all tasks related to configuration and maintenance of business rules within the ecosystem, including COSMOS, UNET, HealthRules, and others. Key responsibilities include:

• Configuration and implementation of new markets and products.
• Management of business rules that support reimbursement policies and methodologies, member/provider contracts, enrollment, billing, role-based security, and correspondence.
• Identification, research, and resolution of inaccuracies and inconsistencies in the system as they impact claims payment and other upstream and downstream transactions and processes.
• Focus primarily on benefits and claims configuration within the HealthRules Payor application.

Qualifications

• Bachelor’s degree in Business Administration, Healthcare Administration, Healthcare Management, Healthcare Informatics, or a related degree program; or an equivalent combination of education and related work experience.
• 1+ years of related experience, including configuration knowledge, system workflow, and/or design.
• Proficiency in Microsoft Office Suite, including Excel and/or Access.

Requirements

• Experience implementing and configuring health plan core administration systems (e.g., FACETS, QNXT, Trizetto, MetaVance, HealthRules, IKASystems, Amisys, COSMOS, UNET) strongly preferred.
• Healthcare experience strongly preferred.
• Claims processing, claims adjudication, and coding knowledge (CPT, HCPC, ICD-10, Revenue, DRG, or other relevant medical and industry-standard codes) strongly preferred.
• Demonstrated ability to meet deadlines.
• Strong commitment to quality and service.
• Strong verbal and written communication skills.
• This position is a remote role and will work remotely 100% of the time.
• Candidates must have a primary home address located within any state where Medica is registered as an employer.

Benefits

• Competitive medical, dental, and vision coverage.
• Paid time off (PTO) and holidays.
• Paid volunteer time off.
• 401K contributions.
• Caregiver services.
• Generous total rewards package to support employees.