Senior Configuration Testing Analyst

JOB SUMMARY
Responsible for the testing and review of the configuration of AMERIGROUP’s claims paying systems. Tests and reviews all aspects of new contract configuration, contract amendments and project configuration for Authorization Required Qualifiers, Pricing and Benefits. Creates test plans and test cases to test configuration. Reviews configuration by matching configuration in the test environments to configuration in the production environments. Provides coaching and assistance with complex issues to Configuration Testing Analyst I’s and II’s. Serves as liaison with external departments. Conducts monthly quality functions for the department.

PRIMARY RESPONSIBILITIES
Responsible for review of incoming configuration requests to ensure that all necessary files, forms and information are received.
Responsible for testing configuration for new contract configuration, contract amendments and project configuration received from the Reimbursement Configuration department.
Responsible for testing and review of the following configuration components
Benefits: benefit package, rider(s), component(s), benefit(s), keywords, counters and codes and code sets.
Pricing: payclass(es), pay service qualifiers, keywords, counters, fee schedules, codes and code sets.
Authorization Required Qualifiers: codes and code sets.
Responsible for testing configuration of provider, ancillary and facility claims.
Conducts monthly reviews of paper files to ensure file completeness and proper documentation order within each folder.
Generate a monthly report showing root cause analysis for all error conditions reported to the Reimbursement Configuration department.
Communicates business rules to enhance the quality of configuration testing and review to the AVP of Technical Operations.
Maintain business rules inventory and communicate to department.
Negotiate with Reimbursement Configuration any rebuttal resolutions that Configuration Testing Analyst I and II’s have difficulty in resolving.
Manage the updating and accuracy of the work-in-process (WIP) inventory file.
Use the work-in-process (WIP) to ensure timely completion of testing and reviews such that productivity measurements are met.
Provide accurate error condition reporting to Reimbursement Configuration Analysts regarding errors found in testing and review and ensure entry into the BCTD database.
Attend meetings with Reimbursement Configuration Department to determine priority of configuration testing requests.
Represent the Quality Assurance department in cross-functional meetings when necessary.
Complete all forms and communications in a manner that is consistent with other Configuration Testing Analysts.
Provide consulting and coaching to Configuration Testing Analysts I & II to improve the quality, accuracy and timeliness of their testing and review activities.
Adheres to departmental and corporate Policies and Procedures as outlined by Management
Attend improvement training programs when available and offered
Other duties as assigned
REQUIREMENTS
EDUCATION AND EXPERIENCE:

Education
Required: High School Diploma required
Preferred: Associate or Bachelor Degree preferred but not required

Years and Type of Experience
Required: Minimum of two (2) years of Managed Care claims paying experience and two (2) years Managed Care configuration experience with at least 4 years experience in either claims paying or configuration experience.

Specific Technical Skills
Required:
Proficient knowledge of the Microsoft suite of software, including, but not limited to: Word, Excel and PowerPoint.
Excellent knowledge of managed care or health care including, but not limited to claims adjudication and payment, benefit management and authorizations/pre-certifications, provider data and contract reimbursement, capitation, billing, enrollment, and benefits.

Certifications or Licensure
Required: Vendor certification in two or more AMERIGROUP’s claims paying sub-systems or equivalent experience on AMERIGROUP’s claims paying sub-systems.

Other
Required:
Excellent analytical and organization skills
Excellent verbal and written communication skills
Excellent interpersonal skills, including the ability to work with all levels of personnel including, but not limited to peers and Senior Management within the organization
Appreciation of cultural diversity and sensitivity towards target population

PHYSICAL REQUIREMENTS
Must be able to participate in meetings
Must be able to operate a PC for extended periods of time
Must be able to operate and effectively utilize office telephone equipment

AMERIGROUP Associates help make a difference in the hundreds of lives they touch every day. We understand that many of our members are moms and kids who depend on us to help them get the health care their family needs. If you share our commitment to improving people's lives, AMERIGROUP may have a place for you. AMERIGROUP Corporation is committed to associate career development and growth, providing opportunities in a culturally diverse, energetic environment. We take pride in offering extensive training programs, competitive compensation, incentives and excellent benefits including:
Relocation Assistance
Paid Accumulated Leave
Holidays
Medical Insurance
Dental Insurance
Life Insurance
Short-Term Disability
Long-Term Disability
401(k)
Employee Stock Purchase Plan
Flexible Spending Accounts
Employee Assistance Program
Company Sponsored Training
Departmental Incentives
Continued Career Growth and Development Opportunities

AMERIGROUP Corporation, headquartered in Virginia Beach, Virginia, is a multi-state managed health care company focused on serving people who receive health care benefits through public-sponsored programs including Medicaid, State Children's Health Insurance Program, and FamilyCare. The Company currently operates in 9 states and the District of Columbia.

In 1994, AMERIGROUP was founded to respond to the growing need for private-sector partners in state managed health care programs for lower-income families and people with disabilities. Since its inception, AMERIGROUP has been a proven leader in meeting the states' objectives of providing accountability and improving access to health care while still controlling care costs. Today, AMERIGROUP is the largest corporation focused exclusively on the health care needs of Medicaid recipients and the uninsured.

Our mission is to operate a community-focused managed care company with an emphasis on the public sector health care market. We will coordinate our members' physical and behavioral health care, offering a continuum of education, access, care, and outcome, resulting in lower costs, improved quality and better health status for Americans.

If you share our commitment to improving people's lives, AMERIGROUP may have a place for you. We're growing dramatically and would like you to consider working for a leader in the healthcare industry. AMERIGROUP Corporation is committed to associate career development and growth, providing unlimited opportunities in a culturally diverse, energetic environment.