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Business Config Analyst

240484 Requisition #

Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals.  If this describes you, we want to speak with you. You can help us achieve our vision to lead nationally in innovating equitable whole-person health.

Ø  Specific Duties

·        Configures and maintains the business rules within the claims adjudication ecosystem.

·        Configures the Health Rules software from development into the testing and production phases.

·        Provides application and technical support for the Health Rules software as well as troubleshooting for end users.

·        Identifies researches and resolves inaccuracies and inconsistencies in the business rules as they impact claims payment and other upstream and downstream transactions.

·        Determines how to migrate PHO’s to the new system. 

·        Engages in intake with business clients to evaluate business requirements.

·        Recommends and implements benefit setup based on knowledge of system configuration capabilities and information obtained from business clients.

·        Independently evaluates business procedures and problems.

·        Participates in business requirements gathering sessions to identify specifications and solutions.

·        Creates test case scenarios for application and configuration testing and ensures appropriate testing has been completed before the software enters the production phase.

·        Identifies and assesses potential problems and performs and implements system enhancements, modifications and upgrades.

·        Defines with business client data reporting and trending reports and makes recommendations to management.

·        Designs and develops user system documentation.

·        Works with IT to define business systems requirements.

·        Performs investigation, evaluation and documentation of system design findings.

·        Evaluates and monitors coded data elements.

·        Assists users in understanding business system functions. 

·        Additional duties as assigned.

Ø  Knowledge Summary

·        Must have a thorough understanding of the configuration of business rules that support reimbursement policies and methodologies, member/provider contracts, and claims adjudication and correspondence.

·         Must have demonstrated strong analytical, technical and problem-solving skills.

·         Ability to work with multiple business systems and have a good understanding of system design.

·         Demonstrated experience in Microsoft office products and project management tools.

·         Strong communication and analytical skills required to covey complex technical ideas, concepts and applications.

·         Must understand the business environment and associated systems.

·         Must be detail oriented and understand corporate objectives.

·         Must have the ability to follow through on project life cycles.

·         Experience in data analysis, testing and implementation.

·         Technical writing skills needed.

·         Must be able to present findings to management.

·         Must be able to create time-lines and work with internal and external departments to gather appropriate information.

·         Skills in coaching and mentoring.

·         Works independently on projects, identifies and implements business systems solutions with minimal supervision.

·         Good understanding of available resources to investigate, perform testing, analyze and present initial findings.

·         Strong presentation skills required.

·         Knowledge of project management tools and business system methodology

·         Proficiency in Healthcare and Health Plan terminology, medical coding (e.g., CPT, HCPCS, ICD9, CDT, Revenue, DRG and other relevant medical and industry-standard codes)

Ø  Education & Experience

·         Bachelor's degree in Business Administration, Management Information Systems, Computer Science or equivalent work experience.

·         In lieu of degree, minimum 3-4 years proven configuration experience, preferably on Facets, Health Rules, Diamond, Amisys Advance or similar payer system Strong project management skills needed.

·         2+ years HealthCare operations or Healthcare claims processing experience


Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.

Diversity, Equity, and Inclusion

At Independence, everyone can feel valued, supported, and comfortable to be themselves.  Our commitment to equity means that all associates have a fair opportunity to achieve their full potential.  We put these principles into action every day by acting with integrity and respect.  We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace.  Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

About Our Company

Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.


At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations.  For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!


Equal Employment Opportunity

Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability. 

Agency Disclaimer

All resumes submitted directly to an Independence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process. 

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