Configuration specialist

CornerStone Technology Talent Services is seeking for detail-oriented administrative and clerical professional to fill the position of Configuration Provider Specialist in Temple, Texas.

This is a contract to hire position and will require claims processing and health insurance experience.Position SummaryThe Configuration Provider Specialist will be responsible for entering and maintaining provider demographic and contractual data within the claims processing system and working with various departments to answer questions regarding information configured within the provider database.

Main Responsibilties : Maintains provider database, utilizing credentialing data, the National Plan & Provider Enumeration System (NPPES) and other data sources to ensure data integrity within the claims processing system.

Works in conjunction with Network Development to enter new contracts into the system and make modification to existing contracts.

Collects IRS W-9 forms from providers to validate / update configured information.Collaborates with enrollment operations to effectively coordinate member re-assignment upon termination of a Primary Care Provider (PCP).

Assists in the selection of the appropriate pricing template to apply to contracts.Works in conjunction with the Compliance Department to update provider records as appropriate when notified of credible allegations of fraud and identify any claims paid during the alleged period.

Provides assistance with both simple and complex administrative tasks, including but not limited to, entry and validation of data for multiple departments.

Ensures that provider federal tax information found to be in error as identified through IRS B-Notice is updated.Responsible for updating provider configuration as appropriate when notified of an IRS Notice of Levy.

Reviews provider quality reports and update provider records as appropriate to bring configuration in line with company standards.

Aids in the development of new policies and procedures needed as new issues arise and assists in creating business and system requirements to improve the management of provider data.

Performs other position appropriate duties as required in a competent, professional and courteous manner.Minimum Requirements : Associates Degree required.

Join Our Team : CornerStone Technology Talent Services (TTS) is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status, and will not be discriminated against on the basis of disability.

Learn more about us and stay connected : Visit our website : https : / / www.cornerstonetechtalent.comFollow us on LinkedIn : https : / / www.

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Last updated : 2024-05-12