Health Edge Configuration Technician - HealthEdge Operations- Paramount - Full Time - Remote
Paramount Health Care, a ProMedica Health Plan, offers insurance products across six Midwest states. This Ohio-based company, headquartered in Toledo, has more than 685 employees dedicated to serving their health plan members.
Paramount offers Medicare Advantage and Marketplace Exchange health plans for individuals and families. Paramount maintains accreditation by the National Committee for Quality Assurance (NCQA) for their HMO and Medicare Advantage products.
In addition, Paramount has a full complement of insurance products for employers of any size, including medical, dental, vision and workers’ compensation, as well as vocational rehabilitation, life-care planning and wellness.
As a part of ProMedica, Paramount is driven by ProMedica’s mission to improve your health and well-being. ProMedica has been nationally recognized for its advocacy programs and efforts to address social determinants of health. Paramount strives to provide an exceptional experience to every member. For more information about Paramount, please visit our website at paramounthealthcare.com.
This Health Edge Configuration Technician position is for someone who is interested in the design and configuration of HealthEdge HealthRules Payor software (HRP). In this role, they will be responsible for understanding the business requirements given to them from various Paramount departments to create the design, complete the configuration and unit test for appropriate results in HRP. They will assist the workstream lead in the design and configuration of HealthRules Payor for one or more workstreams and/or be assigned as lead for a workstream.
1. Contribute to the cross functional design and configuration of HealthRules Payor, including assisting in gathering business requirements, for an assigned workstream(s)
2. Design configure and unit test business requirements in HealthRules Payor based on documented business requirements for assigned workstream.
3. Assist in the gathering and documentation of business requirements for assigned workstream
4. Read the HealthEdge Connector Guide(s) for workstream(s) assigned to assist on and become familiar with the information available to them
5. Attend department and other related meetings relevant to the assigned workstream
6. Meet all regulatory and assigned deadlines
7. Other duties as assigned
- Education: Bachelor’s Degree or 3 years’ experience working in a healthcare field.
- Detailed orientated and good organizational skills
- Proficient verbal and written communication skills
- Ability to plan, coordinate and organize multiple priorities with minimal supervision
- Experience in medical billing or equivalent knowledge of claim forms and/or medical terminology
- Proficient with Microsoft Office Software with an emphasis on Word and Excel
- Ability to accurately and independently identify problems as demonstrated by taking a basic skills test and scoring a minimum of 80% (exempt is assigned to Design Team during implementation)
- Years of Experience: 3 years Healthcare experience
- Education: Bachelor’s degree or 3 years’ experience working in a healthcare field that includes experience with HealthRules Payor software or is a certified coder. A minimum of one-year experience at a ProMedica owned entity.
- Demonstrated knowledge of government compliance and regulatory requirements
- Certified professional coder
- Years of Experience: 2 years
ProMedica is a mission-based, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio. For more information, please visit www.promedica.org/about-promedica
Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact firstname.lastname@example.org
Equal Opportunity Employer/Drug-Free Workplace
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