Humera - Administrative and Professional Staffing

Provider Demographic Coordinator

7 days left

Minnetonka, MN, United States
Contact For Rate
Aug 13, 2018
Aug 21, 2018
Job Type
Employment Status
Full Time
Humera has multiple positions available for Provider Demographic Coordinator's with a major health care provider in Minnetonka.

The Provider Demographic Coordinator is responsible for the timely loading of new demographic information into the CACTUS, COPIS, COSMOS, DataNet, HealthRules, NDB, and/or Symfact databases. The Coordinator will maintain provider demographic records, as changes occur, to ensure accuracy for claims processing, financial utilization reporting and network reporting, including Access and Availability, directories and regulatory product filings, all of which have direct impact on the member and provider.

This is a long term contract opportunity!

Key Accountabilities

Provider Demographic Set Up and Maintenance (75%)
  • Add, change and terminate demographic information for legal entities, individual practitioners, and complimentary networks in multiple provider databases.
  • Apply proper panel, network and contract updates to ensure claims payment accuracy.
  • Work with internal and external partners to obtain information or clarify requests submitted.
  • Analyze all requests to ensure that proper documentation is provided for the transaction request.
  • Meet department expectations for individual and team production, quality and TAT metrics.
  • Complete projects as directed by management.
  • Manage time commitments and workload and escalate issues as appropriate.
  • Identify and correct set up errors.
Personal and Team Development (25%)
  • Attend and participate in team, department and all-employee meetings.
  • Train and serve as a resource for questions from peers learning demographic transactions. Maintain appropriate communication with other sections of the Network Management team.
  • Identify, research and implement process or technology improvements in alignment with Provider Network and Operations Management yearly goals. Present new and updated policy & procedure documents to supervisor as changes occur and review annually.
  • Provide back up and additional support to other function teams within Provider Network and Operations Management.
  • Perform other duties assigned by management.

  • Associate's degree, or equivalent experience
  • Minimum of four years of administrative work experience
  • Working knowledge of PC software (Word, Excel, and Outlook).
  • Database knowledge and experience
  • Demonstrated ability to deal with customers and rapid changing environment.
  • Health Insurance Knowledge preferred
  • Accountable: Able to meet standards for production, quality and turn-around time
  • Quick Learner: Able to learn quickly and respond to a changing industry and operational environment
  • Results Focused: Ability to prioritize multiple tasks with a focus on results versus activity
  • Quality focused: Attention to accuracy is critical
  • Ability to work as an individual and also as part of a team
  • Professional and courteous demeanor
  • Identify and recommend process or technology improvements
  • Quality is key
  • Tolerance for Repetition
  • Time Management
  • Able to manage thru high volumes and produce results
  • Efficient (use of 10 key and technology)
  • Quick Learner
  • Ability to manage Ambiguity

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