Professional, Group Configuration And Billing Analyst

Full-Time, Exempt

Position is virtual/remote

The Professional, Group Configuration and Billing Analyst is a key contributor responsible for configuring and maintaining the Cognizant/Trizetto Facets system. This role is integral to ensuring accurate and efficient group enrollment and Billing processes, with a particular focus on strong elements of quality assurance and testing. The position demands a unique blend of technical proficiency, critical thinking, and robust communication skills to support routine Group Configuration, billing runs, analyze data, and ensure the proper configuration of plans to network sets to groups. This critical role supports seamless benefit administration and streamlined claims processing.
 

Responsibilities: 

• Develop and implement configuration in the Cognizant/Trizetto Facets system, emphasizing FACETS Configuration and Billing expertise.
• Support routine enrollment from a group setup and configuration perspective for all product lines.
• Support routine billing runs, ensuring accuracy and efficiency in billing processes assist in billing error research.
• Analyze inbound requests, incorporating an in-depth understanding of plans and benefits, before implementing the appropriate configuration. Where appropriate work with Sales and other stakeholder groups.
• Collaborate with cross-functional teams to comprehend business requirements, ensuring transparent communication across departments.
• Ensure the correct cadence of processes is followed, leading to accurate group and customer enrollment, billing, and claims processing.
• Perform root cause analysis for issues related to group setup, billing discrepancies, and enrollment challenges, fully mitigating issues to prevent replication.
• Create and maintain pre- and post-validation reports/queries to proactively discover group setup and Billing issues, iterating processes for issue identification.
• Review system enhancements and industry trends, incorporating FACETS best practices for continuous improvement.
• Develop and maintain accurate process and policy documents related to Group Configuration, enrollment, and Billing.
• Participate in the development and implementation of strategies for corporate and departmental projects.
• Prepare detailed analyses and reports for internal customers, emphasizing billing data and trends.
• Maintain detailed documentation related to work assignments to support audit processes.
• Utilize relational databases used to facilitate configuration, enrollment, billing implementation, and testing.
• Assist with test plan creation, test case scenarios, and detailed test scripts, emphasizing quality assurance.
• Identify and communicate configuration defects.
• Represent the department on committees and project teams.
• Perform other duties as assigned.
   
   

Position Qualifications: 

Minimum Education:  

Bachelor of Science in Computer Science, Healthcare Administration, Business Management, or a related field. Equivalent experience in a healthcare organization is also accepted.

Minimum Experience:  

Experience in utilizing query tools to extract data from relational databases i.e. SQL or advanced Access. Expertise in the maintenance of mapping tables to drive group setup and configuration.  A strong focus on FACETS billing expertise preferred.

Required Skills: 

• Exceptional critical thinking and problem-solving skills.
• Ability to manage multiple assignments with a high level of autonomy and independence.
• Demonstrated skills in Microsoft Excel and relational databases.
• Strong analytical ability.
• Excellent organizational and communication skills.
• Strong elements of quality assurance testing expertise.

Preferred Skills: 

• Configuration experience, especially in FACETS configuration or billing.
• In-depth understanding of healthcare plans, benefits, and enrollment processes.
• Prior Experience working with Microsoft Dynamics, JIRA, DevOps or other work tracking/queueing tools

About MVP

MVP Health Care is a nationally recognized, not-for-profit health insurer caring for members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve.

At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. Specific employment offers and associated compensation will be made individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.

In addition, we offer a comprehensive benefits package that includes:

• Considerable paid time away from work including PTO (Paid Time Off), sick time, service time off, paid holidays, and floating holidays, allowing you to take time off when it suits you best.
• Competitive 401(k) employer matching and profit-sharing program to help you save for your retirement.
• Low premium health benefits including medical, dental, and vision coverage to support your well-being and that of your family.
• Life insurance and disability coverage to ensure financial security for you and your dependents.
• An array of optional benefit plans such as accident insurance and specified disease coverage to protect you from the unexpected.
• Full tuition reimbursement (up to the IRS limit) for approved courses and programs that support continuous learning.
• A best-in-class employee Well-Being program to support all dimensions of your health and wellness.

MVP Health Care analyzes the latest market data to determine employee compensation. Compensation figures listed in a job posting are subject to change as new market data becomes available. The salary range, other compensation, and benefits information is accurate as of the date of this posting. MVP Health Care reserves the right to modify this information at any time, subject to applicable law. More detailed information about totalcompensation and benefits will be provided during the hiring process.

MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com
 

Please apply and learn more - including how you may become a proud member of our team.