Configuration Specialist

2 weeks ago

Temple, United States Insight Global Full time

Schedule: M-F 8 to 5 CST

Must-haves:

  • 2 years of Experience
  • Associates Degree
  • Knowledge of claims process
  • Proficiency with Microsoft Excel
  • Strong analytical skills
  • Experience with Health Insurance

Plusses:

  • Experience with Amisys Advance

Essential Duties and Responsibilities include:

Responsible for entering and maintaining provider demographic and contractual data within the claims processing system and working with various departments to answer questions regarding information configured within the provider database

  • Maintains provider database, utilizing credentialing data, the National Plan & Provider Enumeration System (NPPES) and other data sources to ensure data integrity within the claims processing system.
  • Works in conjunction with Network Development to enter new contracts into the system and make modification to existing contracts. Collects IRS W-9 forms from providers to validate/update configured information & Collaborates with enrollment operations to effectively coordinate member re-assignment upon termination of a Primary Care Provider (PCP).
  • Provides assistance with both simple and complex administrative tasks, including but not limited to, entry and validation of data for multiple departments
  • Responsible for updating provider configuration as appropriate when notified of an IRS Notice of Levy. Reviews provider quality reports and update provider records as appropriate to bring configuration in line with company standards.
  • Aids in the development of new policies and procedures needed as new issues arise and assists in creating business and system requirements to improve the management of provider data.

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