Provider Information Management Specilaist in Meridian, ID at Volt

Date Posted: 7/14/2020

Job Snapshot

  • Employee Type:
    Contingent
  • Location:
    Meridian, ID
  • Duration:
    96 weeks
  • Date Posted:
    7/14/2020
  • Job ID:
    237303
  • Pay Rate
    $20.0/Hour
  • Contact Name
    Volt Branch
  • Phone
    208-375-9930

Job Description

Want to Join a Winning Team? 

Contact Volt today to apply for the following position(s):

Provider Information Management Specialist

Start Date: ASAP

Pay rate: $20.00/hr 

Contract assignment 24 months! Full time opportunitites may be possible for a few of the high performers!

** This position starts remote and then moves on-site. Exact details TBD **

POSITION PURPOSE:

To assure timely and accurate provider system administration, to include new provider set ups, configuration updates and contract implementation. Ensure that all provider files, grids, policies and procedures are maintained with current information including provider network configuration and agreements.  Assure timely and accurate medical and dental claim reviews and resolution of complex claims as a result of claim-to-provider configuration mismatch. Provide assistance to Benefits Administration in resolving claim issues due to system or provider configuration problems.

MINIMUM POSITION REQUIREMENTS:

Required Experience:

  • Two years health related experience (to include one year provider file data experience)

Required Knowledge, Skills and Abilities (KSAs):

Knowledge of:

  • Provider file data
  • Provider contracts
  • Procedures associated with health care provider license
  • Contracting requirements by provider type
  • Claim processing procedures
  • CPT, HCPS, ICD-10 claims coding

Skills:

  • Microsoft Word – Basic
  • SQL – Basic
  • Microsoft Excel – Intermediate
  • Ten Key 75 kspm
  • Analytical
  • Attention to detail

Ability to:

  • Adapt to ever changing priorities
  • Organize work to ensure contracts are implemented timely
  • Learn new systems as business evolves
  • Take the initiative to research and resolve issues involving other departments

 

PREFERRED QUALIFICATIONS:

  • Experience with as a Provider Information Management Specialist I
  • Provider reimbursement methodologies
  • Medical terminology
  • Medical billing and claims filing experience
  • Experience with provider file configuration

PRIMARY ACCOUNTABILITIES:

  1. Participate in contract implementation projects and serve as the contact implementation representative when interacting with other departments.
  2. Assure feasibility of implementation on proposed standard provider contracts for all lines of business.
  3. Verify credentialing status before implementation of contracts. 
  4. Implement new or change existing standard provider contracts and assure accuracy with proper system implementation against the corresponding provider contract.
  5. Maintain active communication with Provider Network Specialist, Provider Relations, Information Systems, Facets Integration Department and Claims Administration to address questions and concerns regarding contract set up, implementation, and payments.
  6. Analyze provider contracts with available reports and suggest changes to enhance operational productivity and improve efficiency.
  7. Develop and implement process improvements pertaining to Provider Information Management department. 
  8. Advise Supervisor of significant information that has a bearing on business including, but not limited to payment discrepancies.
  9. Process claims inventory as needed.
  10. Consistently ensure timely and accurate resolution of claims.
  11. Recognize, investigate and report immediately any abnormal claim practices or system configuration issues to the Supervisor for review.
  12. Assist staff recognize and report problems and potential errors in provider file.
  13. Perform training for new and current staff on claims resolution.
  14. Assist in development of procedures and business rules for claims resolution.

SECONDARY ACCOUNTABILITIES:

  1. Keep informed and be responsive to any change in services and programs provided by health care providers.
  2. Randomly audit existing contract payment methodologies for accuracy and facilitate corrections as necessary.
  3. Assist Provider Information Management Specialist III with area training as requested by the Supervisor.
  4. Assist Provider Information Management Specialist III and Supervisor with review of provider queries, system problems, claims testing, and special projects, as requested by the Supervisor.
  5. Stay current on all information related to claims processing such as CATs, BAGs etc.
  6. Perform other duties as requested by the Supervisor.

Interested Candidates can apply by sending a resume toboise@volt.com OR applying via indeed OR via jobs.volt.com. We are also available by phone or text at 208-375-9930.  HURRY THESE SPOTS WILL FILL FAST!!!

“Volt is an equal opportunity employer”