Workflow Data Analyst

Dentaquest

Grafton, Massachusetts

JOB DETAILS
SKILLS
Analysis Skills, Business Processes, Claims Processing, Communication Skills, Computer Science, Configuration Management, Consulting, Continuous Improvement, Customer/Client Research, Data Analysis, Database Design, Database Technology, Debugging Skills, Dental Insurance, Detail Oriented, Establish Priorities, Health Insurance, Information Technology & Information Systems, Interpersonal Skills, Microsoft Office, Microsoft SQL Server, Microsoft SharePoint, Microsoft Transact-SQL (T-SQL), Operations Management, Organizational Skills, Presentation/Verbal Skills, Problem Solving Skills, Procedure Development, Process Development, Process Improvement, Process Validation, Requirements Management, Root Cause Analysis, SQL (Structured Query Language), SQL Databases, Scripting (Scripting Languages), Systems Administration/Management, Systems Analysis, Systems Maintenance, Team Player, Testing, Underwriting, Use Cases, User Interface (UI) Requirements, Writing Skills
LOCATION
Grafton, Massachusetts
POSTED
9 days ago
Job Description

Under moderate supervision, the Workflow Systems Configuration Analyst I is responsible for working with business teams in defining and maintaining Windward Workflow configuration, including queues, reject codes, reject actions and pends, key words, suspend reasons, RFS codes, holds, queue security, and other configuration data that drives claims processing.  The Workflow Systems Configuration Analyst I is also responsible for defining and maintaining system reference, global system settings and building bulk data loads for other configuration data such as fees and client data, and ensuring proper use of core systems functionality in alignment with corporate goals.  Consults with operations, business implementation and IT development teams to understand the impact of functional changes to systems configuration, assists in developing system solutions, and debugs system issues. The Workflow Systems Configuration Analyst I understands business problems and/or requirements, recommends solutions to meet/solve those requirements using existing system functionality and provides excellent support to UM, Claims Operations, Underwriting, and Dental Management and other operational departments to enable them to best serve our customers. 

 

JOB RESPONSIBILITIES:

 

  • Works with UM, Claims Operations, Underwriting, and Dental Management and/or other operational teams in the implementation of new business and other enterprise projects involving the Workflow configuration of our dental systems, including aspects of client configuration.
  • Manages and maintains configuration data required for core claims processing system settings.  
  • Troubleshoots, researches, and corrects assigned tickets/issues that may be related to system configuration, in order to determine root causes including process and validation gaps, training, system defects, etc.
  • Translates client requirements into solutions using core systems configuration settings.
  • Works with IT systems analysts and developers in order to help solve system defects, providing subject matter expert input into use cases, as well as supporting testing of new system functionality or hotfixes related to Workflow and Client systems configuration.
  • Understand, specify, test, and approve relational database scripts designed by configuration development resources.
  • Manage and specify user interface requirements for effective configuration management.
  • Ensures accuracy of system configuration pre and post implementation
  • Ability to define and generate test plans for new configuration settings and systems coding
  • Supports total quality and continuous improvement by recommending standards, procedures and process improvements.
  • Working with Client Configuration, customers, vendors and management, analyzes requirements against current system functionality, develops and deploys proposed solutions to business requirements of moderate complexity.
  • Works closely with internal departments and operations management to streamline systems processes.
  • Maps coding and temporary/pre-production data to build SQL scripts and relationship statements and maintain configuration data.
  • Consults on system/technical aspects of new business implementations and core system enhancements, as they relate to Client configuration as assigned.
  • Adhere to DentaQuest business processes.
  • Other duties as assigned.


Job Description

Under moderate supervision, the Workflow Systems Configuration Analyst I is responsible for working with business teams in defining and maintaining Windward Workflow configuration, including queues, reject codes, reject actions and pends, key words, suspend reasons, RFS codes, holds, queue security, and other configuration data that drives claims processing.  The Workflow Systems Configuration Analyst I is also responsible for defining and maintaining system reference, global system settings and building bulk data loads for other configuration data such as fees and client data, and ensuring proper use of core systems functionality in alignment with corporate goals.  Consults with operations, business implementation and IT development teams to understand the impact of functional changes to systems configuration, assists in developing system solutions, and debugs system issues. The Workflow Systems Configuration Analyst I understands business problems and/or requirements, recommends solutions to meet/solve those requirements using existing system functionality and provides excellent support to UM, Claims Operations, Underwriting, and Dental Management and other operational departments to enable them to best serve our customers. 

 

JOB RESPONSIBILITIES:

 

  • Works with UM, Claims Operations, Underwriting, and Dental Management and/or other operational teams in the implementation of new business and other enterprise projects involving the Workflow configuration of our dental systems, including aspects of client configuration.
  • Manages and maintains configuration data required for core claims processing system settings.  
  • Troubleshoots, researches, and corrects assigned tickets/issues that may be related to system configuration, in order to determine root causes including process and validation gaps, training, system defects, etc.
  • Translates client requirements into solutions using core systems configuration settings.
  • Works with IT systems analysts and developers in order to help solve system defects, providing subject matter expert input into use cases, as well as supporting testing of new system functionality or hotfixes related to Workflow and Client systems configuration.
  • Understand, specify, test, and approve relational database scripts designed by configuration development resources.
  • Manage and specify user interface requirements for effective configuration management.
  • Ensures accuracy of system configuration pre and post implementation
  • Ability to define and generate test plans for new configuration settings and systems coding
  • Supports total quality and continuous improvement by recommending standards, procedures and process improvements.
  • Working with Client Configuration, customers, vendors and management, analyzes requirements against current system functionality, develops and deploys proposed solutions to business requirements of moderate complexity.
  • Works closely with internal departments and operations management to streamline systems processes.
  • Maps coding and temporary/pre-production data to build SQL scripts and relationship statements and maintain configuration data.
  • Consults on system/technical aspects of new business implementations and core system enhancements, as they relate to Client configuration as assigned.
  • Adhere to DentaQuest business processes.
  • Other duties as assigned.


Required Experience
  • BS or equivalent and 2 - 4 years work experience in health or dental insurance, computer sciences or related field, or equivalent combination
  • Demonstrates strong analytical skills with a working knowledge of the business in order to effectively translate business needs to process and system functionality
  • Excellent interpersonal skills
  • Intermediate level experience using MSOffice applications, including SharePoint
  • Excellent oral and written communication skills
  • Shows initiative to learn more and take on more challenges
  • General working knowledge of SQL Server Transact SQL and database concepts and able to write SQL queries of low to intermediate complexity.
  • Strong orientation to detail and problem solving ability
  • Strong organizational and prioritization skills.


Skills & Requirements

Required Experience
  • BS or equivalent and 2 - 4 years work experience in health or dental insurance, computer sciences or related field, or equivalent combination
  • Demonstrates strong analytical skills with a working knowledge of the business in order to effectively translate business needs to process and system functionality
  • Excellent interpersonal skills
  • Intermediate level experience using MSOffice applications, including SharePoint
  • Excellent oral and written communication skills
  • Shows initiative to learn more and take on more challenges
  • General working knowledge of SQL Server Transact SQL and database concepts and able to write SQL queries of low to intermediate complexity.
  • Strong orientation to detail and problem solving ability
  • Strong organizational and prioritization skills.

About the Company

D

Dentaquest

At DentaQuest, our mission is to improve oral health for all Americans. To make it more affordable and easier to access – with a greater focus on prevention. We call what we do Preventistry. It’s our “all-in” strategy to revolutionize oral health in ways that make us all healthier. DentaQuest is a different kind of healthcare company. We bring a uniquely holistic perspective – as we manage dental and vision benefits for more than 30 million Americans – and provide care directly through our growing network of clinics in communities around the country. As a result, we understand how to align incentives to drive better outcomes and lower costs. At DentaQuest, business performance and social impact go hand-in-hand. We have provided more than $230 million in funding for research and grant programs to advance oral health in communities across the country. Today, we are continuing these efforts with a greater focus on innovation and impact investing – working closely with oral health leaders and the broader health community to achieve a shared vision for change. Our mission is bold – our commitment is strong. By advancing oral health for everyone, we will achieve better health for all. Welcome to Preventistry
COMPANY SIZE
1,000 to 1,499 employees
INDUSTRY
Healthcare Services
FOUNDED
2001
WEBSITE
http://www.dentaquest.com