HC & INSURANCE OPERATIONS ANALYST

Associate will process and update Provider Data Management and Provider Data Enrollment Resources to the Client's main application according to its policies and procedures defined. In-depth knowledge and experience in the US healthcare (Non Voice) - Provider Data Validation and Provider Data management. Candidate should have 5 years and above experience in US healthcare and into provider enrollment and credentialling. Ability to train the team on new process and process updates. Calibrate with QA's to ensure process knowledge and variance are managed and under control. Ability to create Process SOP, Process Map and identifying the outlier within process. Review Discrepancy report and comments, identify gaps and share with TL. Identify NVA and provide suggestion for automation opportunities. Identify refresher/re-trainable topics, conduct assessments, and certify staff to move to different levels of production. Drive team from the front in case of leadership unavailability. Need to co-ordinate with quality team to identify the root cause and provide appropriate solution to overcome errors. Oversee data integrity of provider records and practitioner records that are loaded in the system. Provide research to correct errors in Provider and Practitioner data output within the provider information system. Maintain quality and production standards as outlined by government regulations and department policies & procedures. Completion of volumes in queue within specified Turn Around Time. Ability to meet their required production and Quality target. Setting productivity /Quality benchmark Handles internal and external inquiries concerning provider forms, demographics, location details and practitioner records. 3 to 5 years of experience in US healthcare working with Provider Data Enrollment and Management. Ability to work in a 24/5 environment; shifts can be rotational. University degree or equivalent that required 3+ years of formal studies. Required schedule availability for this position is 24/5 and the shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend's basis business requirement.