Dallas, TX, 75219, USA
22 hours ago
Configuration Auditor
+ Review contracts to ensure set-up is correct in Payment Index and Configuration + Review state guidance on pricing and benefits and validate against Configuration + Review provider set-up for pricing set-up and alignment + Participate in problem solving of Health Plan benefit, provider, pricing, reporting, operational and system issues. + Perform a variety of tasks related to the resolution of production support issues based on client configurations with the core administrative system. + Support activities to update configuration within the core claims processing system, typically within the areas of Provider Pricing. Potential responsibilities include and may vary by system area of assignment. + Pull Provider pricing report using identified parameters and criteria. + Review Provider Contracts and identify contract specifics and reimbursements. + Review pricing terms from contract and document in contract library. + Analyse pricing terms from Xcelys to match Contract library. + Document and report discrepancies/feedback to Configuration Team for resolution. + Data Validation and Audit of existing plans and contracts in the client database(s) + Database Management & Maintenance
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