About Fallon Health:
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is the only health plan in Massachusetts to have been awarded “Excellent” Accreditation by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.
The Account and Provider Configuration Analyst works within the Configuration and Support department to ensure all new and existing sponsor and provider information is entered into the QNXT system and all other related databases in a timely and accurate manner. He/She also works to ensure all Sponsor related materials are created and sent to appropriate membership and based off of the materials configures the appropriate benefits within the PCS application. He/She works to ensure that all error, data integrity and various reports are processed effectively pertaining to all system applications used.
The configuration work you are responsible for will impact the end result of our health plans as well as the quality of our claims operations, customer care operations, and cost containment & recovery operations. With a strong dedication to excellent quality of work, ensures that our members and providers have a positive experience as part of the Fallon Health network, and that we pay claims correctly and on time, avoiding fines and extra costs. When a health plan operates as expected by our members and providers leads to a great healthcare experience and the best possible outcomes.
College Degree or equivalent experience