Job description
- The salary range for this position is $43,958 - $53,958 / yr
- This is a Full-time position
- Health Insurance Plans
- Flexible Spending Account Programs
- Management or Union Benefits
- Leave Benefits
- Special Leave of Absence Coverage (SLOAC)
- Retirement Savings Plans
- Additional Savings Plan
- Transit Benefit
- Direct Deposits
- Municipal Credit Union (MCU)
- Must have knowledge of Excel, Word, and Access
- Must have excellent communication skills both oral and written
- Must have analytical and problem-solving skills
- Must have the ability to adapt to changes in a fast-moving environment.
- Must be able to work independently and as part of a team to complete assigned tasks
- Must have the ability to multitask with a strong focus on follow-through and attention to detail
- Must be Covid-19 vaccinated
- Work closely with the Core Systems, Claims Department, and BPO, the incumbent will modify existing data to reflect updated provider information
- Review provider information submitted electronically on claim files
- Communicate directly with the BPO Staff to address all provider data issues relative to Medicare, Marketplace, and other BPO claims
- Participate in meetings to address critical issues regarding the Provider Data.
- Participate in System Testing as requested
- Prepare provider load file into Core Systems and address fallouts
- Support and guide Provider Representative I as needed
- Create and/or update newly contracted providers, non-contracted providers, and vendor records in Core Systems
- Link contracted/non-contracted and vendors
- Create new Provider Organizations and/or Address References as it relates to provider sites
- Communicate new Provider Organizations to relevant departments
- Create Contract Templates in accordance with the Provider Contract language
- Work closely with the Credentialing department, the incumbent will modify existing data to reflect contract amendments including the addition of new contract lines
- Process non-credentialed/ancillary providers as received directly from facilities
- Maintain Facilities Table to assist the Data Analysis department with the publication of the Provider Directory
- Communicate with providers and vendors to secure supporting documents for creating and maintaining records
- Communicate with other departments to fulfill requests for changes or additions to provider and vendor records
- Candidate is expected to meet departmental Quality Assurance standards
- Assist in the 1099 reporting process
- Triage and address provider claims issues
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We are committed to our core values: integrity, honesty, and transparency Finding a new position as a physician or allied health professional or filling a critical vacancy in your practice, clinic, hospital, or skilled care facility can be stressful and time-consuming. At Greenlife our mission is to make this process easier for you and help you through all the steps necessary to find that perfect new position or the healthcare professional to round out your team. We understand that every situation is different and our approach reflects that: we value personalized interaction with job seekers and employers, our searches are customized not cookie-cutter and our results speak for themselves: Happy job seekers and employers who found the right professional match through our services.
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