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Provider Network Analyst

Company: AmeriHealth Caritas
Location: Harrisburg
Posted on: January 15, 2020

Job Description:



Provider Network Analyst



Location



Harrisburg, PA



Telecommuter?



No



ID**

18208








Your career starts now. We're looking for the next generation of health care leaders.

At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.


Responsibilities:

Responsible for facilitating or performing root cause analysis and/or the development of reports, studies and data models related to monitoring the accuracy of benefit interpretation, claim payment, provider contract configuration, eligibility processing and revenue generating interfaces for lines of business. Defines and/or implements data modeling tools or reports designed to routinely assess existing operations processes including but not limited to benefit interpretation, claim payment accuracy systems interfaces and integration.

Education/Experience:


  • Bachelor's Degree.

  • Report writing, data analysis, data research in managed care operations.

  • 3-5 years Claims experience.

  • Proficiency with Microsoft Office Suite (Word, Excel, Power Point). Access is a plus. Consistent word processing speed and accuracy of 50 or more words per minute.



Keywords: AmeriHealth Caritas, Harrisburg , Provider Network Analyst, Professions , Harrisburg, Pennsylvania

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