What are the responsibilities and job description for the Network Data Spec II position at elevancehealth?
Job ID: JP00045160
Anticipated Start Date: 01/02/2024
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. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
Responsible for accurate, timely maintenance of critical provider information on all claims and provider databases.
Primary duties may include, but are not limited to:
- Maintains critical provider information on all claims and provider databases.
- Synchronizes 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.
- Candidate will be required to learn internal data systems to update provider records across multiple software platforms.
- Support escalated provider issues education,
- Support provider communication
- Support EFT enrollment
- Support provider inquiries
- Support provider issues and resolution pricing, terms and condition issues.
- Creation of PEGA tickets for pricing and configuration updates.
- Service increased inbound provider call volume.
- Assist providers with Availity provider portal and EFT registration and issues.
Requirements:
- Requires a H.S. diploma; 3-5 years related experience; or any combination of education and experience, which would provide an equivalent background.
Job Type: Contract Opportunity
Additional Details:
- Work Schedule: Monday -Friday 9:00am-5:00 pm (EST)
- Remote role, with the understanding that the candidate must be 50 miles from a Elevance Health PulsePoint location.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, contractors are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
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.