PEC Systems Analyst
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Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota???s leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs. UCare is growing in size, membership, products, geographic coverage, and employees. We???re an organization that???s going places. Be part of a team that cares about you, be part of UCare.
The PEC Systems Analyst assists with entering, updating and maintaining provider data in Amisys. Ensure provider contracts are fully integrated into the Amisys system for proper payment of claims. Respond to internal customer requests and questions, making system adjustments as needed. Assist with the completion of large scale system updates for major care system entities and delegated entities. Specific duties and responsibilities include:
- Set up Standard & Non-Standard Contracts in Amisys, including new practitioner profiles, billing group practice numbers and provider affiliations. Audit Amisys set up and compare to contractual obligations as listed in provider's formal agreement.
- Assist in the research, audit, and resolve Amisys setup issues reported by the claims department, provider assistance center, enrollment department, PNM Coordinators and System Configuration. Utilize detailed knowledge of Amisys to develop correct setup for billing, system affiliations, and contract intricacies for both clinic and practitioner level data. Act as a first response and maintain timely communication with internal customers regarding the status of requests for provider data entry and correction.
- Participate with internal and external committees and Amisys user groups in collaboration with manager. Keep manager informed of changes that will impact UCare. Research and recommend methods to improve or implement necessary changes in a prompt and efficient manner.
- Develop and maintain long term projects to increase Amisys efficiency and accuracy.
- Complete large scale practitioner updates for major system entities and delegated entities.
- Interact and develop effective working relationship with HMO staff, and maintain working knowledge of AMISYS and HMO operations to understand the impact of system changes on processing functions and data reporting.
- Other duties as assigned.
Two year degree or equivalent in computer systems & technology preferred. Demonstrated experience will be considered in lieu of degree.
Minimum of two years experience in a managed health care environment is required. Must possess working knowledge of managed care operations. Advanced PC experience required.
Preferred work experience as a Systems or Business Analyst. System knowledge of Amisys (Reflections) software. System knowledge of Maccess (IMax) software. System knowledge of Cactus software. Microsoft Offce software experience.
As an Equal Opportunity/Affirmative Action employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You???ll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis???just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.