Provider Data Maintenance Coordinator

Position Purpose:  Process claims in the Zero Queue and maintenance of provider contracts.

Responsibilities:

• Process claims in the Zero Queue
• Research Non-Par providers in external platforms
• Maintain Non-Par providers in the system
• Assist in the loading of Participating provider rosters or sites as needed
• Maintain provider rosters
• Maintain Provider Directory data
• Analysis and resolution of tickets coming from the Claims and Provider Relations Departments
• Meet performance goals as established for the position
• Performs additional duties and responsibilities as assigned by management

Qualifications:

• Experience in Medicare Advantage operational and regulatory guidelines
• Knowledge of provider contracts and reimbursement methodologies
• Understanding of claims processing and medical terminology is desirable
• Excellent organizational and communication skills
• Strong analytical and critical thinking skills
• Experience working in a team-oriented, collaborative environment
• Computer literacy: MS Excel, MS Word, etc.

No Third Party Agencies or Submissions Will Be Accepted.   

Our company is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. DFWP   

Opportunities posted here do not create any implied or express employment contract between you and our company / our clients and can be changed at our discretion and / or the discretion of our clients. Any and all information may change without notice. We reserve the right to solely determine applicant suitability. By your submission you agree to all terms herein.