Responsible for maintaining all provider data maintained within CCHP's provider databases. Processes all requests for changes to the provider databases in accordance with departmental policies and procedures. Responsible for development and production of standard and ad hoc reports which is required for routine operations or special projects. Trains other CCHP staff members to generate standard reports from the database as required. Responsible for establishing mechanisms to enhance the existing database applications as needed to improve the quality of data available to health plan staff. Assists with Single Case Agreement information and various provider participation inquires. Assistance with claims payment inquiries. Assists with incoming communication to the Network Development department, and performs general duties to support CCHP operations.
Associate degree preferred but not required.
Five (5) experience working with database applications such as Access, word processing, spreadsheet and graphic presentation applications.
Superior Access database, Microsoft Word, and Excel skills.
Three (3) years of claims experience including both paper and electronic claim submissions.
Good oral and written communication skills.
Strict attention to detail, including analysis, documentation, oral presentations, general organization and specific organization of personal work duties.
Willingness to continuously improve skills in database and related applications.
Willingness to continuously improve knowledge base in both health care and provider contracting and management.