Provider Installation Analyst
Texas Children's Hospital•Bellaire, TX
About The Position
We are searching for a Provider Installation Analyst -- someone who works well in a fast-paced setting. In 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.
Requirements
- Required H.S. Diploma or GED
- 2 years required experience in Managed care, provider data configuration, and/or claims processing
Nice To Haves
- preferred bachelor’s degree
- preferred TX Medicaid experience
Responsibilities
- Updates provider information as reviewed via a report/database or directly from a claim in an accurate and timely manner to meet the department’s 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
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
