Position Purpose:
Configuration and maintenance of provider contracts and benefits
Responsibilities:
- Configure and load provider contracts
- Maintain provider rosters
- Maintain Provider Directory data
- Test provider contract and fee-schedules
- Review provider data integrity reports
- Resolve claims related tickets
- Train system users
- Meet performance goals as established for the position
- Perform additional duties and responsibilities as assigned by management
Qualifications:
- Experience in Medicare Advantage Plan, managed care or healthcare environment at large
- Experience with provider contract configuration and claims processing
- Knowledge of PCP, specialist, hospital and ancillary contracts
- Analytical and critical thinking skills
- Ability to manage priorities and execute tasks in a high-pressure environment
- Computer literacy: MS Excel, MS Word and MS PowerPoint
- Bachelor’s degree preferred; an equivalent combination of education and experience will be considered
Note: This description indicates, in general terms, the type and level of work performed and responsibilities held by the team member(s). Duties described are not to be interpreted as being all-inclusive or specific to any individual team member.
No Third Party Agencies or Submissions Will Be Accepted.
Our company is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. DFWP
Opportunities posted here do not create any implied or express employment contract between you and our company / our clients and can be changed at our discretion and / or the discretion of our clients. Any and all information may change without notice. We reserve the right to solely determine applicant suitability. By your submission you agree to all terms herein.
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