Provider Network Records Specialist

This job was posted by https://www.kansasworks.com : For more information, please see: https://www.kansasworks.com/jobs/13274774 Responsible for screening, intake, processing and maintaining provider network primary source documents to ensure provider record is accurate. This position will involve processing changes, terminations, and provider roster lifecycle. Provider data accuracy audits current and prospective network providers will be performed and reported provider network management and BCBSKS audit and compliance audiences. Serve as initial intake and workflow assignment for network enrollment and completion of maintenance processes. **What youll do**

• Act as initial point of contact for intake and workflow assignment of provider network enrollment and record maintenance submissions.
• Serve as the primary contact for provider data accuracy inquiries and coordinate the resolution to update all systems relative to data accuracy. ```{=html}
  
  

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• Performoutreach to providers verifying data accuracy utilizing e-mail, fax, phone call. Document findings on data outreach ensuring current provider data metrics identified as required or standard by the Association, CMS, federal, and state legislated guidelines, and/or BCBSKS business needs are met in all data updates.
• Educate providers on the importance of data accuracy and encourage their use of the portal for data accuracy validation.
• Complete procedures for all updates and maintenance of provider records in all systems relative to data accuracy.
• Assist in establishing and maintaining annual project plans on the continual need to ensure provider data is accurate andproviders are engaged in the process.
• Participate on conference calls and audit activities related to provider data as requested. **Knowledge/Skills/Abilities**
• Must be able to learn and apply network contracting knowledge throughout enrollment processing.
• Ability to work well with multiple active work items and adhere to both complimentary and competing service level agreements.
• Employ independent and procedural thinking skills to complete records within defined data entry systems.
• Understand sequential workflow procedures.
• Work with high degree of accuracy to complete record update processing within defined quality and compliance standards.
• Must comply with corporate information security standards and guidelines relative to access control.
• Proficiency in utilizing a personal computer is required with knowledge of Microsoft Office suite products. Proficiency in use of provider records systems within six months of hire. ```{=html}
  
  

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• Must embrace and demonstrate the companys core competencies and values of integrity, dependability, service, growth and progress, and courage. **What you need**
• High school graduate or equivalent is required.
• One years of experience operational experience within BCBSKS to include customer service, claims or membership OR 2 years demonstrated experience working with clinical data management or medical insurance is required.
• Preferred experience with data verification process on extracted data or experience comparing data from multiple systems for accuracy.
• Demonstrated verbal and written communication and human relation skills with the ability to interact positively at all levels with internal and external peers. **Physical Requirements**
• Some lifting of moderately heavy items up to 15 pounds relative to any printed procedure or training manuals.
• Position will be PC work up to 90% of the day to include keying, electronic communications, and virtual meeting attendance; phone usage up to 75% of the day.
• For onsite position assignment, sit / stand desk is available.