Configuration Specialist (8875)

DescriptionTerros Health is a healthcare organization of caring people, guided by our core values of integrity, compassion and empowerment, with diversity woven throughout. We engage people in whole person health through an integrated care delivery system, thus establishing a medical home for our patients. In caring for the whole person, we focus on overall wellness through physical health, mental health and substance use care. Our mission is to provide extraordinary care by empowered people through exceptional outcomes.

This position assists the Director, RCM and other Configuration Specialists in correctly configuring the company practice management system (NextGen) in context of medical policies, reimbursement policies, clinical editing policies, regulatory requirements and contract details to ensure appropriate billing, payment/encounter posting, and reporting of all claims processing activities. This position reports to the Director of Revenue Cycle Management.

HOPE ~ HEALTH ~ HEALING

Develop and maintain an understanding of current payer and NextGen configuration rules, contracts, and policies.

Assists in the accurate and timely loading of the following (including annual updates)

o Payor contracts

o Providers

o Fee schedules

o Code set mapping.

o Specialized rules and alerts in Nextgen EPM

Develop and maintain configuration documentation and communicate configuration processes, changes and best practices.

Assists in the development and execution of test scenarios for configuration changes

Assists in the maintenance of system flags and understands the impact of the system flags on the claims and EHR system.

Develop and monitor post-production audit reports to ensure the intent of NexGen EPM configuration related change and/or project requirements are met

Run and analyze ad-hoc reports

Meets department production and quality standards.

Assists in preparing and delivering reports and recommendations on claims payable accuracy and timeliness and related configuration opportunities to enhance revenue cycle department performance.

Assist in the implementation of high-level quality and performance management initiatives.

Accountable for outstanding customer service to all external and internal customers.

Develops and maintains effective relationships through effective and timely communication.

Take initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner.

Documentation of approved software changes, updates, patches and notification of software releases including the tracking of action items and capturing software changes.

Maintain all applicable configuration baseline documentation

Participates in code reviews, fixes any defects, and performance problems discovered in testing; and participates in transitions of the application components to the testers.

Coordinates and assists the Director of Revenue Cycle Management in outside vendor audit compilation and tracking.

Use sound judgment to determine when to escalate issues and to whom to ensure the highest quality resolution

Benefits & Wellness

We invest in the health, well-being, and success of our employees and their families by offering comprehensive benefits, wellness resources, and opportunities to grow both personally and professionally

Multiple medical plan options, including a no-premium plan for employees and their families

Multiple dental plan options, including orthodontic coverage

Vision insurance

Group life and disability insurance

Pet insurance

401(k) plan with company match

Interest-free medical line of credit

Financial education, planning, and support resources

Monetary company contribution toward eligible benefits

Bilingual pay differential

Generous Paid Time Off (PTO) – 3 weeks off in the first year

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