Network Data Spec I

Job ID: JP00044516

Anticipated Start Date: 05/28/2024

Please note this is the target date and is subject to change. BCforward will send official notice ahead of a confirmed start date.

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for contract workers (via BCforward) who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Responsible for accurate and timely maintenance of provider information on claims and provider databases.

Primary duties may include, but are not limited to:

• Assists in synchronization of data among multiple claims systems and application of business rules as they apply to each database.
• Validates the data to be housed on provider databases and ensuring adherence to business and system requirements of customers as it pertains to contracting, network management, and credentialing.
• They will go and look to see if a contract is needed (they will not generate contracts).
• They will add pricing and determine effective date.
• They will also send the provider to get loaded in the system.
• They need to validate they are able to pay claims and appear in the directory by that effective date.
• Might need to validate information on NPI registry.

Requirements:

• Requires a H.S. diploma; basic PC office software; or any combination of education and experience, which would provide an equivalent background.
• 1-3 years experience in claims processing, provider, or credentialing preferred.
• Insurance knowledge, credentialing, NPI, and medical experience.
• Previous provider data knowledge desired.
• Healthcare background; credentialing; claims processing are the skills needed.

Job Type: Contract opportunity.

Additional Details:

• Shifts: 8am-5pm M-F.
• Occasional OT may be required.
• 100% WFH remote position.
• Training will be virtual.
• Training hours and shift hours are the same.
• Anticipate 2 weeks of training.

About BCforward:

Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward’s 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCforward 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 based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.

This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.