25 Jan
Specialist, Provider Data Management
Kentucky, Frankfort , 40601 Frankfort USA

Vacancy expired!

It’s Time For A Change…Your Future Evolves HereEvolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.Are we growing? Absolutely – about 40% in year-over-year revenue growth in 2018. Are we recognized? Definitely. We have been named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016, 2017, 2018 and 2019, and one of the “50 Great Places to Work” in 2017 by Washingtonian. We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.What You’ll Be Doing:What You’ll Be Doing:This position is responsible for status reporting and coordinator of daily work for their client team, including issue escalation and confirmation of team priorities. Maintenance of provider data within claims processing system, including managing credentialing variables and demographics (credentialed and non-credentialed providers), contract or fee schedule assignment and contract and network affiliations based on weekly provider files submitted by clients. Work and troubleshoot claims that suspend in provider data management work queues for lack of provider match in the claims processing system, including working with Technical Operations and members of management to increase auto adjudication of claims by seeking alternatives to current workflows. Researching National Provider Identifier (NPI) numbers and gather similar licensure data on providers entered into the claims processing system, to ensure each provider is appropriately loaded. Participation in problem solving of the monthly 837 Encounter File submissions and error corrections (if applicable). Auditing provider demographics pre-payment cycle to ensure accuracy. Other duties related to system and report data integrity. Maintain upward communication with management regarding development within areas of assigned tasks and perform special projects as required or requested. Provide insight and share best practices that can be reusable across teams with the Line of Business or Department or escalate issues that may impact other teams or lines of business. Comply with HIPAA, and all internal policies and other corporate and departmental policies. Maintain complete confidentiality of company business.Key Competencies/Success Factors:Lives the values: Integrity, Community, Collaboration and Stewardship, as defined in the performance appraisalProficient PC skills in a Microsoft Office based environmentExcellent verbal and written communication skillsDetail oriented with good organizational skills and ability to enter data with accurately in a timely mannerAbility to work collaboratively with associates and other departmentsAbility to handle multiple projects simultaneouslyAbility to adapt to fluctuating situations and perform work of a detailed nature, avoiding errorsPreferred Experience We Look For:BA preferred or equivalent work experienceMinimum of two years’ experience in healthcare field related to credentialing, provider enrollment, providers services and/or configurationTechnical requirements:Currently, Evolent employees work remotely temporarily due to COVID-19. As such, we require that all employees have the following technical capability at their home: High speed internet over 10 MBPS and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.Evolent Health is committed to the safety and wellbeing of all its employees, partners and patients and complies with all applicable local, state, and federal law regarding COVID health and vaccination requirements. Evolent expects all employees to also comply. We currently require all employees who may voluntarily return to our Evolent offices to be vaccinated and invite all employees regardless of vaccination status to remain working from home. Certain jobs require face-to-face interaction with our providers and patients in client facilities or homes. Employees working in such roles will be required to meet our vaccine requirements without exception or exemption.Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.Compensation Range: The typical range of employees within the compensation grade of this position is $40,000 - $60,000. Salaries are determined by the skill set required for the position and commensurate with experience and may vary above and below the stated amounts.

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