Provider Tech Sppt Analyst II

Horizon Blue Cross Blue Shield of New Jersey•Newark, NJ

11h•$63,000 - $84,420•Onsite

About The Position

This position is accountable for providing support to Network Data Management and all departments utilizing provider date including the screening of provider loading, as well as coordinating all procedural aspects relative to the Government Programs provider systems. This position is also responsible for handling important or sensitive projects and priorities that require a high degree of attention and performing other duties as assigned by management.

Requirements

High School Diploma/GED required.
Minimum of 5 years relevant work experience in provider data management in Healthcare/ insurance is required.
A valid driver-s license and access to an automobile is required
Must be willing to travel to various healthcare facilities in NJ.
Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Outlook; should be knowledgeable in the use of intranet and internet applications.
Requires excellent attention to detail.
Requires excellent analytical abilities and the ability to report findings accurately.
Requires excellent oral and written communication skills.
Requires the ability to interact with all levels of personnel and management.
Requires the ability to organize and prioritize work assignments.
Requires the ability to work independently and exercise sound business judgment.

Nice To Haves

Prefer a comprehensive understanding of healthcare.
Prefer an understanding of healthcare provider and claims systems
Prefers and understanding of indemnity and managed care business and procedures
Prefer the ability to understand medical terminology and medical procedures.

Responsibilities

Assists with the direction and supervision activities of the Provider File Area to ensure the accurate, complete and timely maintenance of the Government Programs provider data files.
Resolve provider data errors by identifying causation and recommend improvements, identifying strengths and documenting best practices. Investigates all incidents impacting the data integrity and programs to allow for analysis of trends and potential vulnerability.
Assist in the preparation, development and analysis of specifications for system enhancements and modifications to ensure provider files integrate properly with current and planned systems.
Produces and develops specifications and user testing criteria while securing appropriate documentation to assure accurate data in file.
Evaluate and recommend improvements to specific current operating procedures to enhance operating efficiencies and controls.
Handle important or sensitive projects and priorities that require a high degree of attention.
Produce departmental reporting for quality and production, including vendor audits.
Provide departmental representation on workgroups and committees.