Provider Installation Analyst

We are searching for a Provider Installation Analyst -- someone who works well in a fast-paced setting. In this position, you will be responsible for accurate and timely maintenance of provider information from claims and Provider databases and reports. Validates that provider information entered on databases adheres to business policies and State requirements.

Think you’ve got what it takes?

Job Duties & Responsibilities

• Updates provider information as reviewed via a report/database or directly from a claim in an accurate and timely manner to meet the department’s standards of turnaround time and quality
• Maintains thorough and precise documentation for tracking all provider changes and/or issues for audit purposes
• Monitors pended claims and work queues to update appropriate systems. Responsible for escalating non-standard data or data that does not meet the Business requirements, making recommendations, and assisting with implementing changes to improve the accuracy and efficiency of processes
• Identifies claims impacted by configuration changes done in the system and sends reports to the claims administration department for reprocessing
• Handles fluctuating volumes of work and prioritizes work to meet deadlines and needs of the Health Plan
• Assists in training current staff and new hires as necessary
• Participates in training sessions if and when system updates applied
• Reviews and tests systems for conformance to functional and performance requirements
• Provides input to project implementation plan
• Participates in defect resolution for assigned business applications and communicates with management to address problems and resolutions
• Assists, supports, and trains other internal users to ensure consistent system responsibility of ownership and knowledge

Required H.S. Diploma or GED with a preferred bachelor’s degree

2 years required experience in Managed care, provider data configuration, and/or claims processing with preferred TX Medicaid experience

About Us

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.

To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.

Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.