Responsibilities:

• Analyzing and processing provider transactions in accordance with plan provisions.
• Should follow the policy and procedure which is defined by the customer.
• Secure the PHI information. - Established working knowledge and application of a specialized technical skills.
• Understands how work impacts results for their area.
• Demonstrates knowledge of internal operations and develops relationships to facilitate workflow.
• Knowledge of related regulations and standards.
• Strong understanding of current processes and procedures and may identify opportunities for improvement.
• Completes a wide range of tasks and assignments.
• Projects and assignments are typically non-routine and variable in nature.
• Resolves more complex situations by applying demonstrated knowledge and skills generally acquired through job experience.

Qualifications:

• High school Diploma or equivalent.

• 3+ years of experience in a Health care processing (Provider Data Management preferred, Claims or other Healthcare Payer/ Provider experience)

Preferred Skills/Experience:

• Experience in Provider Data Management and/ or Provider Credentialing
• Experience in Appian, ServiceNow is a plus
• 3+ years of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, leverage internet search engines, and other web based applications.
• 3+ years of experience with the Microsoft Office suite that required daily usage of Outlook, Excel and Word.
• Ability to type 40 WPM