Provider Configuration Specialist

Job Overview:

Provider Configuration Specialist is responsible for ensuring all providers are configured in Hamaspik’s claims system with appropriate contracts so that claims are priced correctly and provider data transfers properly to other Hamaspik systems. Responsible for overall provider data accuracy.

Essential Responsibilities:

·         Ensuring all provider setup requests from all departments are completed in QNXT in timely fashion.

·         Configuring new provider contracts and contract amendments.

·         Updating of necessary fee schedules in QNXT.

·         Completing Provider not Found report daily.

·         Completing Provider Missing Address report weekly.

·         Updating CODA Alias report weekly.

·         Reviewing and completing setup requests sent via Salesforce tasks.

·         Ensuring accuracy of provider data entries.

·         Terminating provider contracts/records as needed.

·         Verifying appropriate contract assignment for all providers in QNXT.

·         Responding to department and configuration related emails.

·         Assisting with completion of other projects and Provider Relations related tasks as needed.

Specific Knowledge, Skills, and Abilities:

·         Knowledge of provider configuration on major claims systems, preferably QNXT.

·         Strong organizational skills.

·         Detail oriented and able to prioritize multiple demands.

Required Education, Experience, and Licenses:

·         Experience in system configuration preferred.

·         Knowledge of hospital, facility, and practitioner payment mechanisms preferred.

·         Knowledge of Medicare and Medicaid preferred.

·         Proficiency in Microsoft Office (Word, Excel, and Outlook) a must.