Network Data Specialists I, II, Senior
Elevance Health

Description

Location: (remote US)

Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. Beacon Health Options is a proud member of the Elevance Health (formerly Anthem, Inc.) family of companies.


As a Network Data Specialist, you will be responsible for accurate, timely maintenance of provider information on claims and provider databases. Level II and Sr level associates will handle the critical and more complex provider information. Sr level will also handle synchronization of data on all claims and provider databases and have expertise on business requirements for multiple business regions.

Primary duties may include, but are not limited to:

• Assists in synchronization of data among multiple claims systems and application of business rules as they apply to each database.
  
• Validates the data to be housed on provider databases and ensuring adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
  

Sr level associates duties will also include:

• Leads the department in problem identification, analysis, and resolution for multiple system provider database issues.
  
• Participates in system testing and analysis in support of new functionality, new system processes, and business rules changes.
  
• Researches and resolves complex exceptions and error reports, determine regional/cap/business indicators for multiple business areas to assure accurate reimbursement based on provider contract and area fee schedules.
  
• Determines training needs and train less experienced associates and outside customers on multiple provider data base systems and business requirements.
  
• Audits for functional and business applications, and report accuracy standards.
  

Qualifications - External

Primary Requirements:

These positions will be filled as Network Data Specialist I, II or Sr. The hiring manager will determine the level to be offered each candidate based on the skills and experience demonstrated.

Level I Requires:

• H.S. diploma;
  
• Basic PC office software; or
  
• Any combination of education and experience, which would provide an equivalent background.
  

Level II Requires:

• H.S. diploma and
  
• Minimum of 3 years related experience; or
  
• Any combination of education and experience, which would provide an equivalent background.
  

Sr Level Requires:

• H.S. diploma and
  
• Minimum of 3 years Provider Database Rep experience; or
  
• Any combination of education and experience, which would provide an equivalent background.
  

Preferred requirements:

• 1-3 years experience in claims processing, provider, or credentialing strongly preferred for all levels.
  
• Strong competency using Excel preferred
  

Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Elevance Health approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

This job has expired.