Reimbursement Implementation Specialist II
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Hanover • Maryland, New York • 🇺🇸 United States
Visit company websiteSalary
💰 $63,161 - $108,276 per year
Job Level
Mid-LevelSenior
About the role
- Synchronizes data on claims and provider databases and provides expertise on business requirements for multiple business regions.
- Identifies, analyzes, and resolves issues for multiple system provider databases.
- Participates in system testing and analysis in support of new functionality, new system processes, and business rules changes.
- Validates the data to be housed on provider databases and ensures adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
- Researches and resolves complex exceptions and error reports.
- Determines regional/cap/business indicators for multiple business areas to assure accurate reimbursement based on provider contract and area fee schedules.
- Determines training needs and provides training to less experienced associates and outside customers on multiple provider data base systems and with multiple business requirements.
Requirements
- Requires a H.S. diploma or equivalent and a minimum of 3 years provider database experience; or any combination of education and experience, which would provide an equivalent background.
- Claims support experience strongly preferred.
- Maryland Medicaid or Public Sector Medicaid account knowledge strongly preferred.
- Intermediate to Advanced Microsoft Excel experience preferred.
Benefits
- a comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
data synchronizationdata validationsystem testingissue resolutionbusiness analysisprovider database managementcontractingnetwork managementcredentialingtraining
Soft skills
problem-solvingcommunicationanalytical thinkingteam collaborationcustomer service