Configuration Analyst/Benefit Coder

This position supports Kaiser Permanente’s code of conduct and compliance by adhering to all laws and regulations, accreditation and Licensure requirements, and internal policies and procedures. Kaiser Permanente is proud to be an equal opportunity/affirmative action employer. DEPARTMENT: PRODUCT & BENEFITS SCHEDULE:  Full-Time Regular; 40 hours per week; Day shift; Monday through Friday; 08:00AM – 05:00PM. EDUCATION/LICENSE/CERTIFICATION: 4-year degree in related field or equivalent experience.  JOB SUMMARY: The Configuration Analyst II works with the Product Managers and Developers to define, code, configure and maintain detailed benefit services and benefit plans designs for the applications that require benefit information.  The Configuration Analyst helps to bring products to market that meet customer (e.g., member, broker, consultant, employer, etc.) needs and expectations and ensures that product and operational goals are achieved.  The Configuration Analyst makes sure benefits are well defined and can be configured in all applications that require benefit data.  The incumbent provides consultation and support to all other employees responsible for configuring benefits into Kaiser Permanente benefit systems.  The incumbent also ensures that the benefit coding definitions are consistent across the organization.  The incumbent will provide subject matter expertise throughout the organization for benefit coding, billing and benefit configuration and ensure consistency and compliance of benefit coding definitions across applications.  The Configuration Analyst clearly understands the products and healthcare benefit services offered to our customers, including cost share, limits, accumulators, and regulatory rules and guidelines.  The Configuration Analyst II function will leverage applicable components of the Product Development Management Process (PDMP) and Comprehensive Delivery Process (CDP) to bring KP products to the market QUALIFICATIONS:  2-5 years benefit configuration/ coding experience. Working knowledge of policies, practices and systems. Frequent use and general knowledge of industry practices, techniques, and standards. General application of concepts and principles. Full use and application of standard principles, theories, concepts, and techniques. Working knowledge of benefits, benefit administration and health care delivery from either/both a payor or provider perspective, along with insurance industry practices and systems. Proficiency in medical terminology, medical coding (CPT4, ICD9 and HCPCS) and common claims adjudication practices. PREFERRED QUALIFICATIONS2-5 years experience of related Health Plan, Medical Group, hospital or insurance analytical and/or consulting experience. EPIC Benefit Engine, Tapestry AP claims or Diamond claims desirable. Medical and billing coding certification preferred. BA/BS strongly preferred.Some Health Insurance, Health Plan Administration, Healthcare, Benefit Administration, or Benefit Policy experience a plus. Product Management and or Project Management  experience preferred. Industry Standard Coding knowledge strongly preferred. SKILLS TESTING:  N/A DUTIES:  The Configuration Analyst II, under limited supervision Participate in and provide technical/research support, performing the most complex analysis for benefit design in support of Product Development initiatives. The position is responsible for providing expert knowledge, impact analysis and recommendations related to configuration design and assist in configuring benefits. The Configuration Analyst II, will create coding definitions for all benefits, especially complex benefit designs.  This work includes the developing tools and templates to support the work. This position will write and run queries for analysis, will recommend and implement the process to analyze, design, configure, code, QA and maintain detailed benefit designs. The Configuration Analyst II, serves as a coding expert to others and provides assistance to employees and physicians in the interpretation and translation of benefit services into medical and billing codes. The configuration analyst ensures coding and configuration meets current business policies and practices and supports the efforts of compliance review and audit of employer group benefits. The Configuration Analyst II, creates and analyzes reports to determine plan for benefit configuration and develops and executes test plans for configuration testing. This position participates in, and may lead, cross-functional teams of personnel on routine and entry-level scope activities that support Product Development agenda, processes, and programs. They will review and creates policies and procedures to implement coding best practices and makes recommendations to management on Program needs to achieve strategic objectives. The Configuration Analyst II position develops presentations of recommendations and findings to departmental management and cross-functional leadership, creates benefit coding documentation to support benefit configuration in all applications that require benefit data and communicate all coding changes. The incumbent will collaborates with the Benefit Manager to ensure that a comprehensive Project Plan exists for key benefit initiatives and Coordinate all work team to develop benefit codes. Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanente's policies and procedures. Kaiser Permanente conducts compensation reviews of positions on a routine basis.  At any time, Kaiser Permanente reserves the right to reevaluate and change job descriptions, or to change such positions from salaried to hourly pay status.  Such changes are generally implemented only after notice is given to affected employees.  - Kaiser Permanente is an AA/EEO employer - Additional Information Reference Code: RE.0801635 Position Type: Full Time, Employee