System Configuration Analyst Location: Tustin, CA 92782 Fully Remote LIBERTY Dental Plan Corp. - Tustin, CA 92782; Remote - Corp - Tustin, CA 92782 Position Type Full Time Category Operations Description Configure Systems. Improve Accuracy. Strengthen Outcomes. Do you thrive at the intersection of claims expertise, system configuration, and cross‑functional collaboration? Are you energized by solving complex Utilization Management (UM) and claims scenarios while ensuring systems work exactly as designed? LIBERTY Dental Plan is seeking a System Configuration Analyst to help ensure our claims and UM systems are accurate, efficient, and aligned with benefit design and regulatory expectations. In this highly collaborative role, you’ll partner with Claims, UM, Account Management, Quality Management, Compliance, and IT teams to configure, test, and maintain system logic that directly supports high‑quality service delivery and sound operational outcomes. What You’ll Do You’ll support the end‑to‑end effectiveness of claims and UM system configuration through testing, analysis, and coordination: - Coordinate, track, and complete claims and UM‑related projects - Analyze and process complex claim and UM scenarios - Assist with benefit implementation and claims/UM system configuration - Coordinate with cross‑functional teams to implement and maintain member notifications related to claim and UM decisions and outcomes - Support research projects and new business implementations as needed - Partner with management to create, update, and maintain departmental policies and procedures - Audit and test existing system code rules and provide recommendations for improvement - Audit and test new and existing benefit setups related to claims and UM adjudication - Support Crystal Report implementation related to claims and UM activities - Perform other duties as assigned What You Bring Required - Bachelor’s degree - Minimum of 2 years of experience in PPO and HMO claims processing, billing, and/or auditing - Proficiency with Microsoft Office tools, including Word, Excel, and Access - Strong written and verbal communication and presentation skills - Advanced analytical skills, including data‑mining, reporting, and analysis - Ability to reason logically, make sound decisions, and communicate effectively under varied circumstances - Ability to multitask and work efficiently with interruptions or competing priorities - Looking for someone with HSP systems knowledge, dental procedure knowledge, HSP denial explanations, Service restrictions, Basic data analytics experience Preferred - Prior auditing experience Who You Are You are someone who: - Enjoys detailed, systems‑focused work and process testing - Is comfortable navigating complex benefit and adjudication logic - Collaborates effectively across departments with differing priorities - Maintains composure and accuracy in fast‑paced or high‑stress situations - Takes pride in producing reliable, well‑documented results Work Environment - Primarily remote, office‑based work - Role involves extensive computer use, data review, and system testing - Requires sustained attention to detail and coordination across multiple teams Ready to Make an Impact? If you’re motivated by precision, collaboration, and improving how claims and UM systems serve members and providers, we encourage you to apply and bring your expertise to LIBERTY Dental Plan. Qualifications Location Our employees are distributed in office locations in multiple markets across the United States. We are unable to hire or allow employees to work outside of the United States. What Liberty Offers Happy, healthy employees enhance our ability to assist our members and contribute more actively to their communities. That’s why Liberty offers competitive and attractive benefit packages for our employees. We strive to care for employees in ways that promote wellness and productivity. Our first-class benefits package supports employees and their dependents with: - Competitive pay structure and savings options to help you reach your financial goals. - Excellent 401(k) retirement benefits, including employer match, Roth IRA options, immediate vesting during the Safe Harbor period, and access to professional financial advice through Financial Engines. - Affordable medical insurance, with low-cost premiums for employee-only coverage. Liberty subsidizes the cost for eligible dependents enrolled in the plan. - 100% employer-paid dental coverage for employees and eligible dependents. - Vision insurance with low-cost premiums for employee-only coverage and dependents. - Company-paid basic life and AD&D insurance, equal to one times your base salary, with options to purchase additional supplemental coverage. - Flexible Spending Accounts for healthcare and dependent care expenses. - Voluntary benefit programs, including accident, critical illness, and hospital indemnity insurance. - Long-term disability coverage. - Expansive wellness programs, including company-wide wellness challenges, BurnAlong memberships, and gym discounts. - Employee Assistance Program (EAP) to support mental health and well-being. - Generous vacation and sick leave policies, with the ability to roll over unused time. - 10 paid company holidays. - Tuition reimbursement for eligible educational expenses. - Remote or hybrid work options available for various positions. Compensation In the spirit of pay transparency, the base salary range for this position is $65,000 - $75,000 a year, not including fringe benefits or potential bonuses. At Liberty, your final base salary will be determined by factors such as geographic location, skills, education, and experience. We are committed to pay equity and also consider the internal equity of our current team members when making final compensation decisions. Please note that the range listed represents the full base salary range for this role. Typically, offers are not made at the top of the range to allow for future salary growth. Liberty Dental Plan commits to maintaining a work environment that acknowledges all individuals within the workplace and will continue to engage in practices that are inclusive of all backgrounds, experiences, and perspectives. We strive to have every person within the organization have a sense of belonging while encouraging individuals to unleash their full potential. Liberty will leverage diverse perspectives in building high performance teams and organizational culture. Liberty Dental Plan will continue to strengthen and develop external partnerships by providing equitable health care access and improving population health in the communities we serve. We comply with all applicable laws and regulations on non-discrimination in employment, recruitment, promotions, and transfers, as well as work authorization and employment eligibility verification requirements. Sponsorship and Relocation Specifications Liberty Dental Plan is an Equal Opportunity Employer / VETS / Disabled. No relocation assistance or sponsorship available at this time.

• Manage small and moderately complex projects • Establish and implement new or revised system requirements or procedures • Analyze user requirements, develop and implement systems for moderately complex processes • Coordinate activities of project team and act as a source for direction, training and guidance for less experienced departmental staff

Role Description Employees are responsible for triaging, investigating, and resolving potential instances of healthcare fraud and/or abusive conduct by medical professionals or providers. Using information from tips, complaints, external intelligence or behavior data, the medical community and law enforcement, employees conduct confidential investigations and document relevant findings and report any illegal activities in accordance with all laws and regulations. Identify, communicate, and recover losses as deemed appropriate. These investigations may include participation in telephone calls or meetings with providers, members, clients, legal, compliance, and other investigative areas and requires adherence to state and federal compliance policies, reimbursement policies, and contract compliance. Where applicable, testimony regarding the investigation may be required in a court of law. - Perform root-cause and trend analysis and translate findings into prevention (policy recommendations, new detection rules, training opportunities, control improvements). - Utilize appropriate documentation and tracking controls in the case tracking system to ensure compliance and auditability requirements are met. - Collaborate with SIU Investigator to apply knowledge of coding guidelines to determine validity of aberrances. - Gather all relevant facts to articulate behavior through an Investigation Summary and compliance package. - Collaborate with a variety of external sources to identify current and emerging patterns and schemes related for FWA. - Provide case direction and mentorship to investigators/analysts (work planning, quality checks, documentation standards, coaching on interviews and evidence development). - Develop and deliver case presentations to leadership, clients, and compliance (case theories, evidence summaries, overpayment methodology, recommended outcomes). - Ensure confidentiality and data handling compliance (PHI/PII, minimum necessary, secure sharing, retention requirements) and coach others on the same. - Maintain SOPs and training materials; lead calibration sessions to improve consistency in decisioning, documentation, and case outcomes. - Track and report SIU metrics/KPIs (cycle time, recoveries, outcomes, inventory health, referral sources). - Perform member and provider interviews, and review medical documentation as needed. - Communicate with legal, Law Enforcement, clients and business partners as needed. Qualifications - High School Diploma / GED - Professional certification as a Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified Professional Coder (CPC), or similar - 5+ years of experience working in a FWA / SIU or Fraud investigations role - 2+ years of experience within the health insurance claims industry - 2+ years of knowledge and/or experience with medical/behavioral health codes and service delivery - 2+ years of experience working with law enforcement or legal entities or 3+ years of investigative experience with fraud investigations - 2+ years of experience with computer research - 2+ years of experience with regulatory compliance - 2+ years of experience with data analysis as it relates to financial recovery/settlements - Intermediate level of proficiency in Microsoft Excel (pivot tables and macros) and Word (creating, editing, and saving documents) - Familiar with CPT code terminology Preferred Qualifications - Associate degree in the area of Criminal Justice or experience in a related field Benefits - Comprehensive benefits package - Incentive and recognition programs - Equity stock purchase - 401k contribution (all benefits are subject to eligibility requirements) Salary Information The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

Role Description We are seeking an experienced Interface Analyst to join our Integration Team supporting a consolidated, enterprise-wide Epic environment. In this role, you will own the end-to-end build, support, and troubleshooting of real-time HL7 interfaces connecting Epic with various clinical vendor systems. The ideal candidate brings deep technical expertise in Epic Bridges and the InterSystems Ensemble/IRIS platform, alongside a proven track record of maintaining high-availability clinical data flows in a live production environment. Long Term Contract Pay: $90/hour on W2 100% Remote Key Responsibilities - Design, build, test, and deploy real-time HL7 interfaces between Epic and third-party clinical vendor systems using InterSystems Ensemble/IRIS and Epic Bridges. - Provide hands-on, tier-3 production support and troubleshooting for interface failures, data discrepancies, and connectivity issues in a live, high-volume Epic environment. - Collaborate with clinical application teams, system administrators, and external vendors to integrate specialized systems, including Radiology/PACS, Cardiology, Document Management, and Clinical Communications. - Monitor error queues, tune interface performance, and manage code/configuration migrations through regular Epic upgrade cycles. - Maintain detailed technical documentation, interface specifications, and data mapping diagrams while ensuring adherence to HIPAA and data security standards. Qualifications - Active Epic Bridges Certification is mandatory. - Preferred Certification or formal training in InterSystems Ensemble, Health Connect, or IRIS. - Minimum of 3–5 years of hands-on experience managing and configuring interfaces within Epic Bridges. - Proven experience building, routing, and supporting real-time interfaces using InterSystems Ensemble (also accepted as InterSystems IRIS, HealthShare, or Health Connect). - Direct interface build and support experience across at least two of the following domains: - Radiology / PACS systems - Cardiology / Hemodynamics (e.g., Cath Lab, Echo) - Document Management / Enterprise Content Management (ECM) (e.g., OnBase or equivalent) - Nurse Call / Clinical Communications Middleware