Humera - Administrative and Professional Staffing

Provider Enrollment Analyst

7 days left

Location
Minneapolis, MN, United States
Salary
Contact For Rate
Posted
Oct 15, 2017
Closes
Oct 26, 2017
Job Type
Employee
Employment Status
Full Time
Humera Administrative Staffing is seeking a Provider Enrollment Analyst to work for our client, an independent, nonprofit health plan provider in Minneapolis, MN. Our client is dedicated to improving the health of its members through innovative services and partnerships across communities. This is a temporary contract set to start immediately and run through the beginning on February of next year.
Duties:
  • Assist with entering, updating and maintaining provider data in Amisys
  • Ensure provider contracts are fully integrated into the Amisys system for proper payment of claims
  • Respond to internal customer requests and questions, making system adjustments as needed
  • Assist with the completion of large scale system updates for major care system entities and delegated entities.
  • Set up Standard & Non-Standard Contracts in Amisys, including new practitioner profiles, billing group practice numbers and provider affiliations
  • Audit Amisys set up and compare to contractual obligations as listed in provider's formal agreement
  • Use MN-ITS provider list verification to ensure entities and practitioners are approved through DHS prior to setup
  • Use Medicaid verification and OIG Exclusion verification systems prior to setup to ensure that the entities and/or practitioners do not have any sanctions against them
  • Use National Plan & Provider Enumeration system prior to setup to ensure NPI?s are valid as well as provider specialty
  • Participate with internal and external committees and Amisys user groups in collaboration with manager
  • Keep manager informed of changes that will impact UCare
  • Research and recommend methods to improve or implement necessary changes in a prompt and efficient manner
  • Develop and maintain long term projects to increase Amisys efficiency and accuracy
  • Assist with the completion of large scale practitioner updates for major system entities and delegated entities
  • Daily external provider contact via Emails and Phone Calls
  • Daily internal customer issues and concerns via Service Forms, Emails and Phone Calls
  • Ensure department turnaround time guidelines are met and accurate
  • Other projects and duties as assigned

Education
  • Two year degree or equivalent in computer systems & technology preferred; demonstrated experience may be considered in lieu of degree
Required Experience
  • Two or more years of experience in a managed health care environment
  • Must possess working knowledge of managed care operations
  • Advanced PC experience
Preferred Experience
  • Experience as a Systems or Business Analyst
  • System knowledge of Amisys software
  • System knowledge of Maccess (EXP) software. System knowledge of Cactus software
  • Microsoft Office Excel experience
  • System knowledge of SharePoint
  • System knowledge of MN-ITS Provider Lists
  • System knowledge of Medicaid Verification and OIG Exclusion verification
  • System knowledge of National Plan & Provider Numerations

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