Job Description :
Job Title: Data Analyst
Location: Durham, NC 27707
Duration: 3 Months

Role Description:
Responsible for providing analytic support, which includes data collection, trending, reporting and forecasting functions to ensure data integrity.
Will design, develop, analyze and determine reporting controls and procedures for the department.
Compile appropriate information to make requested contractual and demographic updates and changes related to provider data in the systems of record in an accurate, complete and timely manner.
Manage and sustain positive provider relationships.
Configure providers and networks in systems of record, assign provider numbers and communicate with provider community.
Facilitate accurate financial claims payment and provider directory processes.
Represent client to external provider communities and internal stakeholder groups.
Accurately complete provider configuration in provider systems of record to ensure appropriate claims payment in accordance with contractual language.
Compile, analyze, and verify the required information for provider enrollment, contracts, and maintenance for completeness and accuracy, and enter it into the systems of record.
Communicate, orally and in writing, directly with providers to resolve questions and issues regarding updates and changes in the systems of record.
Research, respond to, analyze and resolve complex claims issues related to provider setup and provider eligibility on a daily basis.
Create resolution documents to address provider issues and increase provider satisfaction. Utilize probing and problem solving methods to resolve all inquiries/requests. Identify, understand and anticipate providers’ unexpressed needs and concerns.
Provide cross functional support and serve as Subject Matter Experts (SMEs) or second tier resolution to internal and external provider teams (i.e., PSA team, Credentialing, Contracting, Provider Service Consultants, etc
Manage timely responses to external provider inquiries and requests. Evaluate new service requests from providers to determine appropriate actions for recording into the systems of record.
Perform gap analysis on requests and follows through with communication and/or education to providers on internal client process and issues.
Recommend, and participate in process improvement opportunities for Network Management Operations. Identify system problems, gaps or inconsistencies in workflows and/or processes. Recommend appropriate updates, alternatives and solutions.

Hiring Requirements
Bachelor’s degree in business or health related field with demonstration of strong analytical skills in business, systems or information management (can be through coursework, internships or relevant work experience) If no degree, must have at least 2 years of operations or analysis experience (i.e. in claims or provider service
MS Office knowledge required.

Hiring Preferences
PowerMHS, IPD references, AMISYS,MACESS, Service First, and ECHO knowledge preferred
Prior claims processing experience preferred
Strong analytical skills/problem solving skills
Critical thinking/ability to question
Provider (customer) focused
Interpersonal skills/relationship building
Excellent communication skills with internal and external stakeholders; ability to effectively communicate with provider community in a professional manner
Ability to multitask in a fast-paced production environment
Strong organizational skills/Time management
Takes accountability for work performed
Ability to work both individually and in a team environment with shared goals.
Ability to work under pressure to produce high quality work with defined turnaround goals
Ability to effectively adapt to change
             

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