Job Description

JOB DESCRIPTION:

The Burgess Source Configurator is responsible for configuring, maintaining and optimizing the Burgess Source claims pricing and payment integrity platform. This role ensures accurate reimbursement logic, regulatory compliance and seamless integration with payer systems. The configurator works closely with business, compliance and IT teams to deliver accurate pricing outcomes and support operational efficiency.

RESPONSIBILITIES:

• Understanding of HRP modules and Burgess Source

• Configure, update, and maintain pricing rules and reimbursement logic within Burgess Source.

• Translate regulatory, contractual, and payer-specific policies into system configurations.

• Implement custom fee schedule changes.

• Maintain version control and documentation for all configuration changes.

• Develop and execute test plans for new rules, updates, and platform releases.

• Conduct regression testing to ensure stability and accuracy after changes.

• Investigate pricing discrepancies and perform root-cause analysis.

• Validate outcomes against expected reimbursement methodologies.

• Support data ingestion processes for fee schedules, provider files, and reference data.

• Ensure data integrity and troubleshoot data-related issues.

• Interpret contract changes and ensure timely implementation within the system.

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EXPERIENCE/SKILLS:

MINIMUM REQUIREMENTS:

• Minimum of 5 years of experience in payer operations, claim processing, and experience deploying Burgess source.

• Minimum of 5 years of hands-on configuration experience in Burgess source.

• Must possess working knowledge of Medicare operations, system development and testing.

• Expertise in using Microsoft Office; including Excel, Word, Access, Power Point, and Visio.

• Experience working within a matrix organization. Excellent oral and written communication skills and the ability to interface with all levels of customer organization.

PREFERRED REQUIREMENT:

• Experience in health insurance, payment integrity or claims operations in parallel with Burgess source.

EDUCATION:

• Bachelor’s degree in business or health care preferred; demonstrated work experience may be considered in lieu of degree.

SKILLS:

• Collaboration, leadership, organizational, writing, interpersonal and communication skills.

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Deliver

Continuous Integration, Deployment

100% error free on boarding & implementation, throughput %, Adherence to the schedule

Quality & CSAT:

On-Time Delivery, Troubleshoot queries

Customer experience, completion of assigned certifications for skill upgradation

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