WI3674356

1

Bachelor's Degree

Bachelors Degree

Unspecified

40

JOB REQUIREMENTS: Overview Configures medical and pharmacy benefit
packages, premium billing, finance, eligibility and customer service
sub-system reference files using the managed care software provided by
Epic. Designs, develops and maintains uniform and customized benefit
packages for all insurance products, including HMO, PPO, POS, HSA, EPO,
Medicaid and Medicare Supplement. Assists in operational planning to
ensure interdepartmental accuracy of benefit interpretation and claims
payment. Serves as project leader during system upgrades and
implementation of new functionality. Serves as user support for the
various business areas using the software, including enrollment,
finance, claims, customer service, provider & fee schedule maintenance
and marketing. Process jobs and reports related to Electronic Data
Interchange (EDI) transactions. Perform technical system functions
related to the transfer and retrieval of data files using standard IT
protocols, such as FTP. This position may require occasional weekend
work and flexible hours to meet project deadlines. Performs other duties
as assigned. Responsibilities Essential Duties and Responsibilities \*
Develop and maintain expert level knowledge of Epic software, including
claims, authorization, customer service, enrollment, provider
reimbursement, finance and EDI modules, as well as detailed knowledge of
workflow processes. \* Business analyst suggests ways to maximize
software applications to assist with process improvements and workflow
changes. \* Business analyst works on problems ranging from moderate to
complex, in which analysis of the situation or data requires a detailed
review of factors and issues, and coordination of efforts between
programmers, vendors, system administrators and users. \* Build and
maintain benefit package configuration within Epic \* Coordinate the
loading of software fixes and upgrades, and perform tests to ensure
seamless implementation of new functionality. \* Create and maintain
documentation to track testing and changes to software. \* Coordinate
user system security requests for all applications and systems used by
MercyCare employees, and set up user security according to the most
current security policy. \* Import EDI claims and other transactions
from various sender locations, and run jobs to process files into the
appropriate module, on a daily basis. \* Export EDI remittance advice
files to appropriate provider trading partners. Configure and transmit
EOB and EOP electronic files to vendor for mailing, using standard
transmission protocols. \* Develop and maintain expert knowledge of
third party software and obtain required Epic certification(s) \* Work
with users to ensure Standard Operating Procedures (SOPs) accurately
reflect system functionality and optimization. Culture of\... For full
info follow application link. EOE&AA/M/F/Vet/Disabled. Mercy is an equal
employment opportunity employer functioning under Affirmative Action
Plans. \*\*\*\*\* APPLICATION INSTRUCTIONS: Apply Online:
ipc.us/t/05814B73F1F14F1F