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Corporate Functions & Operations WellCare - Data Analyst Careers

Configuration Data Specialist Job

Full Job Title: Configuration Data Specialist

Job Number: 1701649

Location: Phoenix, AZ

Date Posted: 5-16-2017

Location: Camelback Rd, Phoenix, AZ 85016

Department: Operations

Reports to: Director, Network Management

To ensure accurate and timely loading and maintenance of provider file information through appropriate research. This would include, but not be limited to: initial loads based on claim receipts, provider demographics, vendor information, terminations, and researching, analyzing and making appropriate adjustments to the daily departmental reports.

Essential Functions:

  • Performs accurate and timely provider research, verification and analysis. Including verification of license status utilizing designated web pages when new providers are added to the system.
  • Performs research to respond to inquiries and interprets policy provisions to determine most effective response.
  • Resolves provider load issues within established documented processes.
  • Ensures the proper supporting documentation exists and is maintained on file for all load processes.
  • Loads and maintains provider data.
  • Responds to inquiries from provider field staff,
  • Resolves critical errors forwarded from the claims department.
  • Updates tracking database.
  • Responsible for building and maintaining positive business relationships with business partners.
  • Assists in special projects.
  • Maintains high quality work.
  • Meets productivity expectations.
  • Works Auto Analyzer Reports.
  • Performs other duties as assigned
  • Completes assignments thoroughly, accurately and on time.
Candidate Education:
  • Required: High School Diploma or GED
Candidate Experience:
  • Required: 1 year of experience in health insurance
  • Preferred: 1 year of experience in configuration and/or claims
Candidate Skills:
  • Demonstrated written communication skills
  • Demonstrated interpersonal/verbal communication skills
  • Demonstrated analytical skills
  • Demonstrated problem solving skills
  • Demonstrated time management and priority setting skills
  • Knowledge of Claims Processing
  • Basic understanding of provider types and specialties
Technical Skills:
  • Knowledge of CPT/HCPCS coding
  • Knowledge of provider billing practices

*LI-JC1


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Last Updated On: 12/9/2015