Provider Installation Analyst

Provider Installation Analyst

We are searching for a Provider Installation Analyst -- someone who works well in a fast-paced setting. In this position, you will be responsible for accurate and timely maintenance of provider information from claims and Provider databases and reports. Validates that provider information entered on databases adheres to business policies and State requirements.

Job Duties & Responsibilities

Updates provider information as reviewed via a report/database or directly from a claim in an accurate and timely manner to meet the department's standards of turnaround time and quality

Maintains thorough and precise documentation for tracking all provider changes and/or issues for audit purposes

Monitors pended claims and work queues to update appropriate systems. Responsible for escalating non-standard data or data that does not meet the Business requirements, making recommendations, and assisting with implementing changes to improve the accuracy and efficiency of processes

Identifies claims impacted by configuration changes done in the system and sends reports to the claims administration department for reprocessing

Handles fluctuating volumes of work and prioritizes work to meet deadlines and needs of the Health Plan

Assists in training current staff and new hires as necessary

Participates in training sessions if and when system updates applied

Reviews and tests systems for conformance to functional and performance requirements

Provides input to project implementation plan

Participates in defect resolution for assigned business applications and communicates with management to address problems and resolutions

Assists, supports, and trains other internal users to ensure consistent system responsibility of ownership and knowledge

Skills & Requirements

Required H.S. Diploma or GED with a preferred bachelor's degree

2 years required experience in Managed care, provider data configuration, and/or claims processing with preferred TX Medicaid experience

Founded in 1996, Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Job Identification 424531

Job Category Professional - Non-Clinical

Degree Level High School Graduate

Job Schedule Full time

Job Shift Day

Locations 6330 West Loop S, Bellaire, TX, 77401, US

Texas Children's Hospital