Provider Installation Analyst

We are searching for a Provider Installation Analyst -- someone who works well in a fast-paced this position you will be responsible for accurate and timely maintenance of provider information from claims and Provider databases and reports. Validates that provider information entered on databases adheres to business policies and State requirements.

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Job Duties & Responsibilities

• Updates provider information as reviewed via a report/database or directly from a claim in an accurate and timely manner to meet the departments standards of turnaround time and quality
• Maintains thorough and precise documentation for tracking all provider changes and/or issues for audit purposes
• Monitors pended claims and work queues to update appropriate systems. Responsible for escalating non-standard data or data that does not meet the Business requirements making recommendations and assisting with implementing changes to improve the accuracy and efficiency of processes
• Identifies claims impacted by configuration changes done in the system and sends reports to the claims administration department for reprocessing
• Handles fluctuating volumes of work and prioritizes work to meet deadlines and needs of the Health Plan
• Assists in training current staff and new hires as necessary
• Participates in training sessions if and when system updates applied
• Reviews and tests systems for conformance to functional and performance requirements
• Provides input to project implementation plan
• Participates in defect resolution for assigned business applications and communicates with management to address problems and resolutions
• Assists supports and trains other internal users to ensure consistent system responsibility of ownership and knowledge

Skills & Requirements

Required H.S. Diploma or GED with a preferred bachelors degree

2 years required experience in Managed care provider data configuration and/or claims processing with preferred TX Medicaid experience