Sr. HRIS Analyst managing HRIS administration and support, focusing on project management and analytics. Collaborating with internal customers to enhance HR processes and reporting.
About the role
- Associate Configuration Analyst at Abarca Health managing configurations for Medicare, Medicaid, and Commercial clients while ensuring compliance and accuracy in operations.
Responsibilities
- Process plan configuration setup for new Medicare, Medicaid, Commercial and Employer client implementations, as well as configuration changes for existing clients.
- Perform unit testing to confirm configuration set-up or changes are processing as expected as defined in the client documentation.
- Perform research and resolution of adjudication and processing issues including, identification of root cause, impact analysis determination and corrective action.
- Apply appropriate sense of urgency support to other areas to verify and analyze claims processing cases, eligibility, and other operational situations and issues referred for validation within SLAs/SLOs.
- Responsible for daily tracking and monitoring of assigned requests to ensure due dates are met.
- Support the review, impact analysis, root cause assessment and preventive measures for issue management related workload.
- Continuously develop an understanding of Darwin (proprietary adjudication platform) system logics to ensure benefit designs are configured to meet client requirements with accuracy.
- Make timely adjustments to operations ensuring our processes follow compliance, rules, and regulations of Medicare, Medicaid and State Requirements.
- Collaborate and coordinate with other business units to execute configuration as required.
- Provide feedback on processes and make recommendations for improvements.
Requirements
- Associate or Bachelor’s degree in Accounting, Finance, or related field. (In lieu of a degree, equivalent relevant work experience may be considered.)
- Experience utilizing dashboard tools, (e.g., Tableau, QVW, and Excel tools).
- 1+ years of work-related experience in benefit configuration, Medicare Part D.
- Ability to apply critical thinking skills to manage responsibilities.
- Ability to manage presentations as needed.
- Excellent oral and written communication skills.
- This position requires availability to work in a specified time zone or working schedule, accommodating the business needs of our clients and team members.
- This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable).
Benefits
- Flexible hybrid work model requiring certain on-site workdays (Puerto Rico Location Only)
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Tech skills
Location requirements
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