Sr. Provider Data Maintenance Specialist

1 month ago

Chicago, United States Solving IT Full time

One of the largest health insurers in the nation is focused on continuously building an industry-defining, world-class IT capability. Healthcare is forever evolving, especially due to emerging technologies, making this a great experience to add to your resume. Come join their winning team

This contract role as a Sr. Provider Data Maintenance Specialist in Chicago, IL is responsible for the analyzing, researching, and applying business rules to complete requests received from providers regarding adds/deletes/changes to their information used for claims processing, membership assignment, and directory purposes.

Responsibilities:

        Analyzing, researching, and applying business rules to complete requests received from providers regarding adds/deletes/changes to their information used for claims processing, membership assignment, and directory purposes.

        Contracting, credentialing and maintaining Facility / Professional provider data to support marketing, network contracting across all lines of business.

        Supporting the implementation of special projects, assisting with tracking of various phases of a project and managing workflow.

        Assisting management in familiarizing and training team members with the various business rules in network contracting and credentialing across all lines of business.

        Identifying gaps in processes and suggesting process improvement strategies.

Requirements:

        Bachelor degree plus 1 year of experience with Provider Network contracting and credentialing systems OR 5 years of experience in the Health Care industry.

        Written and verbal communication skills including interpersonal skills. Skills to develop training materials and act as an advisor to staff

        Experience and proficiency inn Microsoft Office software products including analytical tools. Experience developing reports.

Preferred Job Qualifications:

        Subject Matter Expert for the Professional Provider Credentialing Process

        2 years of experience with current government sponsored health insurance networks

        Knowledge of health care delivery systems, claim costing analytics, and provider network adequacy analytics

Benefits: 

Solving IT is pleased to offer a rich benefit plan to our W2 employees. We offer five health plan options and a PPO dental plan through Blue Cross Blue Shield, Term Life/AD&D Insurance, and 401(k) Savings Plan. Solving IT subsidizes the health and dental premium for the employee.

As you continue to develop your skills and experience, Solving IT will work with your changing preferences to match you with rewarding projects. Our unrivaled reputation for quality is demonstrated through our Inavero Best of Staffing award that was won due to the feedback from our own clients and candidates. We also love to socialize and have fun so we have regularly scheduled parties and events for you to unwind and network with fellow consultants. 

Whether you are searching for your next challenge or just looking to stay on top of market trends, Solving IT is committed to help position you appropriately. By leveraging the latest market and compensation data available, you can rest assured that you are getting more than just an informed opinion. You are getting the Solving IT Experience.

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