Description
46558-Contract Benefit Specialist
Rancho Cucamonga, CA 91730
Position type: w2
Contact duration: 5months + (Strong Possibility of Extension)
Description
Creates and maintains configuration artifacts for institutional and professional contracts.
Analyzes provider contracts to determine the best approach for loading data elements into the claim processing system
Ensures the provider configuration meets established quality standards, business rules and procedures.
Consults with relevant Contract Manager or Business Analyst to determine appropriate interpretation and configuration of contract terms.
Develops documents and executes test plans for data loaded
Performs problem resolution of configuration issues and documents results for the repository
Research operational issues, prepare analysis, make recommendation, develop and implement solutions based on information from internal and external sources and clients.
Facilitate and lead cross-functional teams to develop or maintain new processes/policies/programs to support business operational needs.
Provides periodic informal work guidance/direction to and training of team members with less experience
Required Experience:
.*These are the MUST HAVE items. If a candidate does not have these then they will be rejected.*
3 years of experience processing Facility and Ancillary claims..*these are claims for existing support contracts.*
Must have knowledge and experience understanding and working with medical coding..*this is not a HIMS coder*
Deadline-oriented with the ability to manage competing priorities under pressure.
Excellent communication, presentation, analytical and report writing skills.
.*this is a data entry role converting paper contracts and entering them based on the data in the contract, over to system data*
Preferred Experience:
.*These are things that we would like to see, but are NOT required to fill the position. These are NOT disqualifying items.*
None.