The candidate is responsible for handling mid-level support of custom developed accounts receivable software, independent research, and rule authoring. Rule authoring is a form of software development that includes complex computational analysis of system events, conditions, actions, sequencing, branch analysis, and chaining/recursion. Our current rules engine has hundreds of thousands of rules and millions of condition checks that require precise grouping and sequencing to ensure continuity of automated revenue cycle processes. Managing a robust and complex business rule set, as part of a team, includes functions similar to that of software development: debugging, troubleshooting, research, and new rule development.
Job Tasks
- Complete rule adjustments for allowables and charges
- Assist in troubleshooting application issues
- Create effective systems documentation
- Develop knowledge of the business and workflows
- Analyze logical conditional pathways to confirm expected results
- Determine business impacts on workflow and assist in the development of new workflows
- Interpret business requirements into technical specifications
- Develop on-going strategies for productivity improvements
- Analyze rules for logical completeness, correctness, and optimization
- Coordinate and prioritize multiple projects and deadlines
- Conduct independent research with technical staff and subject matter experts
- Recommend changes in testing methods as needed
- Communicate complex information simply
- Complete other assigned responsibilities
- Other Continuity of Operations Duties as assigned
Qualifications
- Minimum of 3 years of experience in healthcare software systems
- Bachelor's degree in Health Information Management, Computer Science, MIS, Informatics preferred
- 1 year of claims processing and reimbursement policy experience or equivalent knowledge preferred
- Proficiency with Microsoft Office
- Proficiency querying Microsoft SQL Server or other relational database is a plus
- Knowledge of structured programming techniques and database methodologies is a plus