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    Configuration Coordinator Specialist - Temple, United States - CornerStone Technology Talent Services

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    Description

    Job Title: Configuration Coordinator Specialist

    Duration of Engagement: Contract-to-Perm

    Location: Temple, TX (On-site)

    Work Hours: Monday to Friday, 8:00 am to 5:00 pm

    JOB OVERVIEW

    This role entails managing and updating provider demographic and contractual data within the claims processing system, and liaising with various departments to address inquiries regarding provider database information.

    PRIMARY RESPONSIBILITIES


    • Update and uphold provider database integrity by utilizing credentialing data, the National Plan & Provider Enumeration System (NPPES), and other relevant sources.


    • Collaborate with Network Development to input new contracts and adjust existing ones in the system.


    • Gather IRS W-9 forms from providers to verify/update configured information.


    • Assist in coordinating member re-assignment upon termination of a Primary Care Provider (PCP), in tandem with enrollment operations.


    • Support Compliance Department in updating provider records in response to credible allegations of fraud and identify any claims paid during the alleged period.


    • Provide assistance in various administrative tasks, including data entry and validation for multiple departments.


    • Ensure correction of provider federal tax information flagged as erroneous by IRS B-Notice.


    • Update provider configuration upon receipt of IRS Notice of Levy.


    • Review provider quality reports and adjust provider records as necessary to align with company standards.


    • Contribute to the development of new policies and procedures to address emerging issues, and assist in formulating business and system requirements for enhancing provider data management.


    • Perform other relevant duties as required, maintaining professionalism and courtesy at all times.

    REQUIRED SKILLS AND QUALIFICATIONS


    • Familiarity with claims processing procedures


    • Proficiency in Microsoft Excel


    • Strong analytical capabilities


    • Preferred experience with Amisys Advance, though not mandatory


    • Prior experience in health insurance

    REQUIRED QUALIFICATIONS


    • 2+ years of relevant experience


    • Associate's Degree

    If interested, please send your cover letter and updated resume to

    Kindly no C2C/C2H for this opportunity



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