- Maintain the provider database using credentialing data, the National Plan & Provider Enumeration System (NPPES), and other sources to ensure data integrity within the claims processing system.
- Work in conjunction with the Network Development team to enter new contracts into the system and make modifications to existing contracts.
- Collect IRS W-9 forms from providers to validate or update configured information.
- Collaborate with enrollment operations to effectively coordinate member re-assignment upon termination of a Primary Care Provider (PCP).
- Assist in selecting the appropriate pricing template for contracts.
- Work with the Compliance Department to update provider records as needed when credible allegations of fraud are identified or any claims are paid during the alleged period.
- Provide assistance with both simple and complex administrative tasks, including entry and validation of data for multiple departments.
- Ensure that provider federal tax information identified as erroneous through IRS B-Notice is updated.
- Responsible for updating provider configuration appropriately when notified of an IRS Notice of Levy.
- Review provider quality reports and update provider records as appropriate to align with company standards.
- Aid in the development of new policies and procedures as new issues arise and assist in creating business and system requirements to improve the management of provider data.
- Perform other duties as required in a competent, professional, and courteous manner.
- Knowledge of claims processing systems.
- Proficiency with Microsoft Excel.
- Strong analytical skills.
- Health insurance experience required.
- Experience with Amisys Advance is preferred but not required.
- At least 2+ years of related experience.
- Associate degree or higher preferred.
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Data Entry Specialist - Temple, United States - Buchanan Technologies
Description
Job Title: Data Entry Specialist - Healthcare
Work Schedule: Monday to Friday, 8:00 AM to 5:00 PM
Parking: Included
Key Skills: Data Entry, Healthcare experience preferred, Proficiency in Excel
Duration: This is a contract to hire position.
Job Summary:
The Data Entry Specialist is responsible for entering and maintaining provider demographic and contractual data within the claims processing system. The role involves collaboration with various departments to address inquiries regarding data configured within the provider database.
Essential Functions:
Knowledge, Skills, and Abilities:
Qualifications:
About Buchanan Technologies
Since Buchanan's inception over 30 years ago, we have operated on 5 core values – People Matter, Customers Matter, Principles Matter, Community Matters, and Every Interaction Matters. These values are represented across each facet of the company, from employee relations to client service delivery to corporate social responsibility initiatives and beyond.
Why Work at Buchanan?
At Buchanan Technologies, we offer a great employment experience with a fun but professional work environment, competitive salary, and various employee career advancement programs that add value to your skills and daily life. If you are excited about being part of an energetic team where your contributions are appreciated and hard work is recognized, Buchanan is the place for you.
Things We Are Passionate About
We are passionate about providing top-tier technology services to our customers and clients and fostering a culture of continuous learning for our employees. We are a people-centric company, focused on growth and diversity for our workforce. Come join us and let's build something amazing together.
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Buchanan Technologies provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, protected veteran status, or genetics. In addition to federal law requirements, Buchanan Technologies complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
