OR - Provider Technical Spec - Senior - Remote

DEPARTMENT DESCRIPTIONSamaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans Inc. offers Medicare Advantage Commercial Large Group and Commercial Large Group PPO and EPO plans; SHP is also the thirdparty administrator for Samaritan Health Services selffunded employee health benefit plan. As part of an Integrated Delivery System Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services mission of Building Healthier Communities TogetherEXPERIENCE/EDUCATION/QUALIFICATIONSAssociates degree or equivalent experience required.Two (2) years experience in Provider Services required.Two (2) years experience in Health Plan Insurance Plans required.Previous Facets experience required.Previous claims experience preferred. Experience in provider data healthcare Provider data entry experience Experience in documenting processes creating workflows and policies Knowledge of compliance requirements and procedures preferred Critical and analytical thinking skills Project implementation preferred Experience in Facets or similar provider data or claims processing system Experience in other provider related healthcare departments such as credentialing provider relations or contracting preferred

Shift: Days () no weekends

Specialty Type: Clerical

Sub Specialties: Medical Staff CoordinatorData Quality Specialist

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