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Sr Prov Data Maintenance Spec - 743

at Health Care Service Corporation in Chicago, Illinois, United States

Job Description

At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.

Come join us and be part of a purpose driven company who is invested in your future!

This is a Union Role
Job Summary
This position is responsible for the analyzing, researching, and applying business rules to complete requests received from providers regarding adds/deletes/changes to their information used for claims processing, membership assignment, and directory purposes. This position is responsible for contracting, credentialing and maintaining Facility / Professional provider data to support marketing, network contracting across all lines of business. This role involves supporting the implementation of special projects, assisting with tracking of various phases of a project and managing workflow. This position includes assisting management in familiarizing and training team members with the various business rules in network contracting and credentialing across all lines of business. In addition is responsible for identifying gaps in processes and suggesting process improvement strategies.

Required Job Qualifications:
* Bachelor degree plus 1 year of experience with Provider Network contracting and credentialing systems OR 5 years of experience in the Health Care industry.
* Written and verbal communication skills including interpersonal skills. Skills to develop training materials and act as an advisor to staff
* Experience and proficiency inn Microsoft Office software products including analytical tools. Experience developing reports.

Preferred Job Qualifications:
* Subject Matter Expert for the Professional Provider Credentialing Process
* 2 years of experience with current government sponsored health insurance networks
* Knowledge of health care delivery systems, claim costing analytics, and provider network adequacy analytics

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
HCSC Employment Statement:

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.

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Job Posting: 11867330

Posted On: Apr 29, 2024

Updated On: Apr 29, 2024

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