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Configuration Analyst Resume Samples
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0-5 years of experience
Responsible for configuration, testing, and support of Matrix MLS (Multiple Listing Service) for Real Estate Boards/Associations
- Used knowledge of RDMS for analysis, scripting, and for troubleshooting application and data interface issues
- Led application change projects, wrote SQL queries to research, and set up business rules to modify MLS functionality
- Using Windows Server 2012, SQL Server 2012, and Matrix 6.7+ (MLS Platform); performed install outlined by PM
- Worked 2nd level support tickets, updated tickets with journal notes, and notated time spent on each part of the project
- Modified data on the live/test environment (MLS website) by importing and exporting XML and CSS files from SQL Server
0-5 years of experience
- Performed Configuration of Institutional and Professional Provider Contracts, Authorizations, and/or General Configuration such as System Edit Rules & Fee Schedules updates into Diamond 950.
- Built and updated Price Rules & Fee Schedules.
- Maintained detailed knowledge and understanding of Diamond 950 rules relative to claims payment.
- Executed configuration testing, tested payable procedure codes, price rules and fee schedules in Diamond 950.
0-5 years of experience
- Part of the [company name] and played an important role in the Payment Policy Management, Denial of claims that are billed inappropriately, Outpatient facility and Configuring rules based on the clients specification under library guidelines.
- Installed and administered pricing analysis/design/structure, database and fee schedule loading, non-par contracts and configuration of assigned pricing tasks and ensured accurate payment under contract terms and methodologies.
- Ensured that the work is achieved within company and departmental metrics and with quality standards.
- Used of various tools such as Team Track and Excel, to ensure departmental policies and procedures.
- Trained and conducted knowledge transfer session to new hires.
- Reviewed, interpreted and loaded provider fee schedules and contracts into various claims payment system, platforms.
0-5 years of experience
Interpreted business and technical requirements; created analysis documentation
- Configured and tested company’s proprietary Total Benefit Administration System based on analysis documents from client requirements
- Created and executed test plans by identification/generation of test participants
- Debugged system defects and documented root cause analyses to maintain client team metrics for ongoing improvement
- Monitored and configure reports and updated database using Structured Query Language (SQL) and user interface tools
0-5 years of experience
- Worked closely with customer service representatives and clients to determine project scope and developed innovative, customized solutions that best fit their insurance underwriting needs
- Coordinated and collaborated with client representatives, IT analysts and other teams to ensure a successful database implementation for new clients
- Provided prompt, courteous service in troubleshooting various application and system issues by asking pertinent questions and gathering relevant information from the client
0-5 years of experience
Assignment via Accenture, original author responsible for creating departmental checklist document detailing specific user-friendly instructions on the process for analyzing, interpreting and configuring provider contract information available in an online format.
- Cross referencing its validity to the provider’s LOA, MOU or other signed and executed contracts and agreements by Kaiser and its provider into a centralized configuration and interpretation document for both the onshore and offshore team members
- Approached by management team to reassess work and help streamline portions of remaining provider loads to meet client’s needs for remaining vendors to be uploaded into claims administration system.
- Worked closely with external and internal leads, imported new vendor contracts via Import Spec Spreadsheets (Excel format) to be uploaded into Epic Tapestry program.
- Maintained changes and or deletions as provider’s contracts terminated.
- Other duties and projects as assigned and requested to meet client’s needs.
- Assisted with Southern/Northern California regions of Epic Tapestry building triplets.
- The ability to read and understand correspondence regarding claims payment & denials, over payments (Payment Integrity Issues). Able to Build, Interpret and understand Insurance Contracts, Daily use of ICD-9, ICD-10 & HPCS/CPT codes
- Certified proficient working knowledge of Epic Tapestry Core & Epic Tapestry AP Modules.
0-5 years of experience
- System analyst for open enrollment, which included interviewing clients for requirements, organizing meetings, and documenting the progress of project.
- Configured employee health plans, including updating rate and plan changes, building workflows, uploading new employee forms, and created test scripts to test system functionality.
- Answered client inquires via, e-mail, phone, and webinars, made system recommendations, and provided training, including system walk throws.
- Updated project plan with the project status, alerted upper management to any milestones, or additional resources.
- Troubleshooted support tickets by researching, collaborating with team members and other departments on similar items.
- Created business documents, managing, and controlling documents on the team SharePoint site.
0-5 years of experience
HCSC-Blue Cross/Blue Shield Of Texas Medicare Contract Office; Facets Benefits Consultant, UAT Testing Analyst, Configuration Analyst
- Ensure updates of CPT, HCPCS, DRG, and ICD-10 codes as well as pricing, billing rates, analysis, data entry, testing and documentation of configuration set up for all Facets applications.
- Translates business rules into effective and efficient Facets configuration
- Gathering and analyzing data in support of business cases, proposed projects and system requirements.
- Prepare and deliver reports, recommendations or alternatives in an effort to streamline processes and improve operational efficiencies
- Define and deploy operational requirements and system goals based off of conducted analysis and agreed upon recommendations
0-5 years of experience
Responsible for implementing and revising quality procedures, policies, and documentation requirements
- Responsible for implementing and managing inspection program
- Record and report information to effectively manage configuration items.
- Plan for performance of scheduled and unscheduled quality assessments and evaluations
- Audit and tracking, including training records, Site Procedures, Purchase Requests, Equipment Purchase Orders, Preventative Maintenance, Site Procedures
- Maintain quality records and prepare quality assurance reports
- Identify and document functional and physical characteristics of configuration items.
6-10 years of experience
Claims Administration
- Work claims queues in the Diamond & Macess systems for Medicare, Medicaid, Commercial, and Internals to configure new and update existing non-contracted and staff physicians & facilities into the system. Load pricing and demographics. Run various Access queries, provide daily & monthly reports on claims inventory. Load Electronic Fund Transfer (EFT) information into the system. Respond to Non-contracted audit errors. Verify hospital claim pricing in Optum/ WebStrat.
- The liaison between the NW Claims management, the Provider Contracting team and our back East partners the NCSS that do the configuration for our contracted providers and hospitals. Work the contracted Provider Configuration & Contract Issues queues. Verify the correct demographics with the NW Provider Contracting & Relations team, then send service forms for corrections. Send any needed claims hold modifications or new requests from the NW Claims management team to the NCSS. Research and review configuration issues, review and reply to all Data Method errors assigned to Provider Contracting, and maintain a log of all the groups currently on claims holds.
- Request and process W9(s) from providers based on claims and 1099 reports from the Accounts Payable department to ensure that the information we have on file for payment matches what is on record with the IRS. Send 1099 B notice letters, and document them in the event of an audit.
- Research returned mail and live checks for the Post-Payment department, request documentation and make updates to configuration as needed, so that checks & explanations of payment can be reissued to the proper payment name and address.
0-5 years of experience
- Interact with internal and external parties as the ongoing technical support for benefits administration interface issues
- Configure complex transmission setup for PS standard files (SFTP, FTP), HIPAA transactions (ANSI X12 834), and SQL Scripting
- Mapped and configured benefits data according to structure specification and tested through transport protocol
- Assisted in the development of processes or technology solutions to streamline setups and the onboarding of vendors.
0-5 years of experience
- Review the different options within any software product and determine the best way to modify the software to meet user needs
- Work closely with a team of system developers, programmers, and business analysts
- Focus on a specific aspect of the business process/software
- Modifies the system to meet the user needs, while maintaining system integrity
- Compiling internal documentation to keep track of changes to the system
0-5 years of experience
- Ensured company and customer standards were implemented.
- Responsible for the coordination of multiple Process and Change Control Boards, both onsite and at major suppliers to ensure all process and engineering changes had been reviewed, analyzed and processed by all functional organizations, using the Product Data Management in house tracking system.
- Assisted in the resolution of audit findings found at a major supplier to improve delivery and schedule time.
- Supported the digitization process of data onto a central company data storage system.
- Created program documentation to reflect current instructions and processes for training of new configuration management employees
0-5 years of experience
Analyze provider contract language and rates as they relate to the eligibility and claims processes
- Configure all provider contracted and non-contracted rates into EZ-CAP, including LOA’s
- Maintain provider module
- Create new/update benefit option codes and provider fee sets
- Run configuration reports
- Updates system’s CPT/HCPCS coding schematics
0-5 years of experience
- Extract and analyze health care data for creation and maintenance of benefits in database (Facets).
- Maintain documentation of business specifications pertinent to the business requirements.
- Create reports and spreadsheets displaying data in a logical and concise manner.
- Process changes in benefit requirements, establish and run test claims for quality assurance.
- Confirm reported defects, establish and process defect resolution.
- Manage Pended Claims for defects and instruction for further processing.
0-5 years of experience
- Analyze business requirements from all the functional teams and translating them to specific configuration settings.
- Analyze current configuration settings and their impact to the business; identifying issues and formulating improvements.
- Establish new processes in support of maintaining the integrity of Ensura system’s configuration setting.
- Designing and structuring business processes.
- Working with Business Analysis teams to document the configuration settings and identifying benefits of these settings to the business
0-5 years of experience
- Analyze incoming business requests to determine appropriate work type, completeness of request and update internal department tracking systems.
- Resolve discrepancies with incoming request. Analyze incoming business documents to determine appropriate system configuration.
- Perform research and analysis on system configuration, updating internal documents and control databases, testing configuration and updating Facets production with appropriate configuration.
- Assist in the resolution of production defects and load errors. Create and execute test conditions including updating appropriate internal departmental tracking systems as directed.
0-5 years of experience
- Assists in managing project to roll out compensation management system for a national insurance company
- Generates daily reports for senior management on status of project
- Provides insights into the possibility of meeting milestones, forecasting the number of defects and potential costs
- Analyzes reports in IBM Cognos ICM for coding errors and makes code changes in order to correct payment issues
- Writes SQL queries to pull data for validation of reports
0-5 years of experience
- Responsible for daily Rejection authorization application processing
- Research provider’s in Tapestry for mapping
- Compile Trio spreadsheets from processors and work subscriber less and false dual tabs and notify claims processors once system is updated.
- Review member benefits/ eligibility pertaining to authorization entries
- Research authorizations in claims database
- Review claims and authorization history if services are retroactively authorized and adjust and notified processor’s to remove authorization from pending report.
0-5 years of experience
- Configure and test domain modules, taking an iterative approach to ensure issues are identified early on to avoid data import delays
- Work with implementation manager to plan and manage all imports, draft import sheets and present to Partner
- Analyze the data and follow-up with Partner to ensure data integrity and import into the Partner’s domain
- Configure data fields, configure security and test security features as laid out by the IM
- Gather all requirements for Partner configuration settings
0-5 years of experience
Provide operational support for assigned National Accounts client base.
- Maintain and update client configuration design to meet client business requirements.
- Document configuration changes based on business requirements.
- Efficiently prepare test strategies and test plans for system configuration changes.
- Write rule specifications for all custom programming for carrier 834 export files
- Collaborate with client’s IT staff to coordinate HRIS enhancements, new releases, and fixes.
- Identify and resolve escalated client and production issues by conducting root cause analysis of issues and resolving them.
- Function as a product subject matter expert for external and internal partners.
- Assist in development of process improvements and provide recommendations to accommodate client needs.
0-5 years of experience
- Create and maintain Group/Benefit additions, terms and changes
- Configure and maintain the claim processing system mapping and all interface modules
- Set-up and file maintenance of all diagnosis, CPT and other medical codes
- Collaborate with client to develop, implement and improve cross functional work processes which support claims processing and proper provider payment
0-5 years of experience
- Interpret data, analyze results using statistical techniques using this to create technical data packages for [company name] suppliers
- Working in a technical environment interfacing with Common PDM, STS, and PRISM.
- Subject Matter Expert in supply chain technologies for affordable manufactured (STAMP)
0-5 years of experience
- QNXT Experience in member, provider and claim portals
- Data mapping of 834
- Test Scenarios
- Testing support for file Export and Imports, both flat file and 834 formats
0-5 years of experience
- Interface with organizational management, program management and customers.
- Attend review boards, manage status reporting and perform audits to ensure baseline integrity.
- Participate in the coordination and administration of assigned configuration management activities relative to identification, control and accounting for systems in accordance with contractual requirements.
- Track and release engineering change and documentation.
- Ensure customer requirements are implemented.
- Support quality process audits.
- Review change accounting activities to ensure compliance with configuration management policies.
0-5 years of experience
Responsible for the Analysis, Design, Build, and Unit Testing of Provider Contracts and Benefits Within the KPCC Platform to ensure accurate and timely claims payment consistent with the Regional and National contractual arrangements made with providers, and employer groups.
- Analyze business requirements to determine best approach for configuration design, testing and implementation.
- Test new versions releases relative to system configuration and documenting results
- Lead business requirements development and solution design process including creation of requirements and design documentation and facilitating sessions with business owners and other team members.
- The analysis and interpretation of professional and institutional contracts from the simple to more complex, and configuring provider services into the epic platform correctly to ensure payment of goods and services.
- Analyze benefit evidence of coverage to determine the best approach to loading benefits plan including, copays, out of pocket maximums, as well as state/regulatory benefit coverage.
- Researching and resolving debarred, and sanctioned provider data and to ensure communication of required system updates to provider contracting and claims operations are implemented in Epic Tapestry.
- Analyze and make recommendations to management regarding system enhancements and communicate system issues and its impact on day to day operations.
- Provide coaching and mentoring to team members, workload distribution, tracking and work flow in the share point system.
0-5 years of experience
- Create and route ECO’s and deviations for manufacturing only
- Create part numbers for manufacturing only and release them into production
- Support production by creating and configuring MBOM only assemblies
- Perform all duties from previous positions
0-5 years of experience
- Creates and maintains procedures and metrics to establish effective results striving for continual improvement
- Enter and review data related to bills of material into the MRP and PDM business systems.
- Reviews source documents for data input verifying accuracy and relevance of the input.
- Work with procurement on quoting and ordering printed circuit boards.
0-5 years of experience
- Analyze business requirements, operational processes, and data relationships & configurations to sustain operations
- Create and maintain documentation pertaining to FACTORYworks and SAP configurations
- Complies engineering bill of materials (BOM), Build Profile, Product Version, Product (ZFRT, HALB and ROH) data from engineering input
- Assists in the review and examination of documents and engineering change orders for continuity and correctness of data line items
- Applies well-established technical methodologies in Configuration Management
- Develop and maintain technical system documentation to include requirements documents, test documents, end user and operator manuals and operator guides for equipment, and process
- Develop training classes for operators, system administrators, maintenance personnel, IT personnel and train-the-trainer
0-5 years of experience
- Strong attention to detail; meet production and 99% accuracy expectations of data input
- Utilize QNXT to manage providers’ Medicaid and Medicare contract, credentialing, and demographic information
- Audit loaded provider records for quality and financial accuracy
- Resolve claims issues by verifying contracts, benefits, and billing information
- Interpret specific state/federal benefits, contracts, regulations, and requirements to reflect in systems
- High level of understanding of inventory systems and processes
- Track provider data and oversee projects as requested
- Assists in training current staff and new hires as necessary
- Comply with HIPAA regulations and maintain confidentiality at all times
0-5 years of experience
- Configure new products for new and existing business.
- Utilize Configuration Migration Utility to move new configuration from test environments to production.
- Validate all configuration
- Create make tables utilizing Access
- Maintain Daily Status Reports
- Participate in all configuration and defect meetings
- Correct all defects
0-5 years of experience
- Interfaced with Government and Navy customer personnel concerning Aegis Training Center (ATRC) configuration and technical status
- Performed CM related functions for ATRC: planning, configuration identification, status accounting, configuration control, audits and data management.
- Assisted in the development and maintenance of CM processes and SOPs
- Software Configuration Change Board (SCCB) facilitation
- Processed new employee security clearances and tracked investigations
- Performed administrative support functions via Joint Personnel Adjudication System (JPAS) eQIP
- Processed necessary badges for government facilities
- Processed incoming/out coming visit requests and certifications
0-5 years of experience
- Enhanced the accuracy and timeliness of pricing system configuration, ancillary system interfaces, and/or report processing through coordination and implementation of new pricing methodologies and revisions to existing pricing rate ids. This includes building and loading files, configuration of rate ids to determine pricing for all claims
- Completed maintenance and set up of procedure codes, fee schedules, qualifier groups in Networx. Defines and performs configuration in Networx to revise existing provider agreements as well as create new agreements
- Confirms accuracy of loads and configuration by using Microsoft Access queries and Excel spreadsheets
- Reduces the number of system errors and pended claims through effective research, analysis, solution development, configuration, test summaries, unit testing, communications and documentation of reactive and proactive issues resolution
- Assures appropriate utilization of system features and requirements by assisting the production staff through testing and updating desk level procedures, and by recommending appropriate action/changes in a timely manner so that production areas have the most current and concise pricing processing procedures
- Ensures proper processing efficiency by supporting the configuration and workflow design and by implementing needed modifications
- Researches and completes root cause analysis of customer service intakes and claim errors related to pricing in a timely manner.
0-5 years of experience
- Develop configuration requirements document and obtain approval from business owners.
- Plan and execute assigned configuration tasks within deadlines.
- Provide system configuration support based on changing business needs
- Assist in system analysis, design, development, and testing activities.
- Provide support in developing, implementing and testing patch releases and system upgrades.
- Develop and maintain configuration policies and procedures.
- Review and recommend changes to existing configuration processes.
- Analyze and resolve configuration issues in a timely manner.
- Provide technical guidance to end users in their assigned job duties, when needed.
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[Configuration Analyst]
Last edited by: Gabriela Barcenas, CPRW, Content Writer II -
Gabriela Barcenas
CPRW, Content Writer IIGabriela is a Certified Professional Resume Writer (CPRW) and career adviser. With 10 years of digital media experience and five years of resume writing expertise, her publication history includes fashion, education, travel, social justice, equitable design and career advice.
