Implementation Manager
CVS Health
Reimbursement Implementation Specialist II
Elevance Health
full-time
Posted on:
Origin: • 🇺🇸 United States • New York
Visit company websiteSalary
💰 $63,161 - $108,276 per year
Job Level
Mid-LevelSenior
About the role
- Provide accurate, timely maintenance of complex provider and reimbursement information
- Synchronize data on claims and provider databases and provide expertise on business requirements for multiple business regions
- Identify, analyze, and resolve issues for multiple system provider databases
- Participate in system testing and analysis in support of new functionality, new system processes, and business rules changes
- Validate the data to be housed on provider databases and ensure adherence to business and system requirements related to contracting, network management and credentialing
- Research and resolve complex exceptions and error reports
- Determine regional/cap/business indicators for multiple business areas to assure accurate reimbursement based on provider contract and area fee schedules
- Determine training needs and provide training to less experienced associates and outside customers on multiple provider database systems and with multiple business requirements
Requirements
- Requires a H.S. diploma or equivalent
- 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
- Candidates not within a reasonable commuting distance from the posting location(s) will not be considered unless an accommodation is granted as required by law
