Provider Analysis Specialist

Company: Health Care Service Corporation
Location: Tulsa
Posted on: February 16, 2020

Job Description:

BASIC FUNCTIONS: This position reports directly to the Unit Manager of Network Operations and is responsible for analyzing, researching, and preparing documentation for implementation of provider contract provisions and changes for all networks for the Plan and Subsidiaries. Successful performance of this function is critical to the company because it directly affects the accuracy of claims processing and the availability of up-to-date provider directories, and has a direct impact on the financial reimbursement of physicians, clinics, hospitals, and other general claims and payables. This position provides customer service to providers as it relates to database issues. Also responsible for analyzing, researching, and resolving claims suspended due to provider database issues for the Plan. In this capacity, the incumbent acts as both a liaison and a mediator between the Plan and BlueLincs claims areas and Health Industry Relations.

JOB REQUIREMENTS:

* High school diploma or GED.

* 18 months experience in claims processing, health insurance customer service or in a Health Industry Relations Provider Database File Maintenance position.

* One year experience using a word processing software.

* Understanding of provider contracting concepts.

* Good verbal and written communication skills.

* Ability to work well with others.

* Ability to work independently on multiple tasks.

* Ability to maintain confidentiality.

* Professional demeanor

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Requirements:

Expertise Network Management / Provider Relations
Job Type Full-Time Regular
Location OK - Tulsa

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants.
If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations.
Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "my account" and click on "View your job submissions".

Keywords: Health Care Service Corporation, Tulsa , Provider Analysis Specialist, Other , Tulsa, Oklahoma