Configuration Architect
- Saint Louis, MO
- $94,000-110,500 per year
- Contract
- Full-time
Duration: 6 Months
Location: St. Louis, MO, USAAs a Configuration Architect, you will be:The Configuration Architects will be responsible for designing, implementing, and optimizing claims, benefit, and pricing configuration processes and systems within our organization. This role requires a deep understanding of claims, benefit, and pricing management workflows, data architecture, and system integrations. The architects will collaborate with various stakeholders to ensure configuration aligns with business objectives and regulatory requirements. They would assist with migrating our duals plans to a new Amisys instance and improving/rearchitecting the way we process these claims.Design & Development
- Develop and maintain a comprehensive claims, benefit, and pricing configuration strategy that enhances system capabilities and supports business needs.
- Design and configure claims, benefit, and pricing processing workflows in accordance with best practices.
- Benefits)Develop and implement strategies for configuring claims systems to effectively manage benefit plans, coverage details, and eligibility criteria
- Benefits) Design workflows that ensure smooth processing of claims based on the defined benefits.
- Pricing) Develop and implement pricing strategies and models that align with organizational goals and market standards
- (Pricing) Design and configure the claims management system to accurately reflect pricing rules, fee schedules, and reimbursement methodologies.
- Collaborate with IT and software development teams to ensure seamless integration of claims systems with other enterprise applications.
- Serve as a key point of contact between business units and IT teams, facilitating effective communication and understanding of claims processes.
- Evaluate and implement new technologies that improve claims processing efficiency.
- Work closely with claims operations, product management, and compliance teams to gather requirements and translate them into functional configurations.
- Serve as a liaison between business units and technical teams to ensure effective communication and understanding of claims processes.
- Create and maintain comprehensive documentation for claims, benefit, and pricing configuration processes and system architectures.
- Develop training materials and conduct training sessions for users on new system functionalities and best practices.
- Monitor system performance and user feedback to identify areas for improvement
- Implement enhancements and updates to claims, benefit, and pricing configurations based on evolving business needs and regulatory changes.
- Ensure that claims, benefit, and pricing configuration processes comply with industry regulations and internal policies
- Assess and mitigate risks associated with claims processing systems
- Ensure pricing configurations comply with relevant regulations and industry standards, including Medicare, Medicaid, and commercial insurance guidelines.
- Minimum of 5-7 years of experience in claims processing, configuration, or a related role within the insurance or healthcare industry
- Proven experience with claims management systems (Amisys) and related technologies (DST, Optum Pricers)
- Strong analytical and problem-solving skills.
- Excellent communication and interpersonal skills.
- Ability to manage multiple projects and priorities in a fast-paced environment.
- Ability to collaborate effectively with cross-functional teams.
- Familiarity with data modelling, system integration, and workflow automation
Karthik Saraswathi
Senior ManagerPAY RANGE AND BENEFITS:Pay Range*: 94,000$ - 110,500$ Per Year*Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc.Benefits: Innova Solutions offers benefits( based on eligibility) that include the following: Medical & pharmacy coverage, Dental/vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP).ABOUT INNOVA SOLUTIONS: Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields.Recent Recognitions:
- One of Largest IT Consulting Staffing firms in the USA - Recognized as #4 by Staffing Industry Analysts (SIA 2022)
- ClearlyRated® Client Diamond Award Winner (2020)
- One of the Largest Certified MBE Companies in the NMSDC Network (2022)
- Advanced Tier Services partner with AWS and Gold with MS
The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.