Vacancy expired!
Job Description
Provider Installation Analyst (EPIC Tapestry) - Remote Duties: Responsible for accurate and timely maintenance of provider information from claims and Provider databases/reports.Validate that provider information entered on databases adheres to business policies and State requirements.Updates provider information as reviewed via a report/database or directly from a claim in an accurate and timely manner to meet 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 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 of current staff and new hires as necessary.Skills:-Knowledge of managed care business practices as it pertains to providers, credentialing and contracts as required by the Health Plan.-A working knowledge of the healthcare industry, preferably health insurance/managed care.-Collaboration, written and verbal communication, detailed analytical skills and organizational skills; ability to manage time with competing priorities; self-motivation; leadership; and ability to work independently with minimum supervision.-Additional preferred knowledge includes: claims processing experience, provider contract configuration, TX Medicaid, Master Provider File.Tapestry Experience:-Experience with provider contracting and setup processes, preferably with the building and maintenance of Triplets.-Claims experience is also preferred.-Analytical experience in current or past roles Health insurance industry Knowledge, specifically MCO (managed-care operations) -Proficient in spreadsheet, and database software Strong organizational and follow-up skills-Analyst will be required to become proficient in EPIC Tapestry Triplets build within 90 days of their start day.Note- A Bachelor's degree may substitute for the required work experience.Required Skills:EPICEXCELVacancy expired!