OR - Provider Technical Spec - Senior - Remote - Tekfortune Inc.
Corvallis, OR 97330
About the Job
Job Description:
DEPARTMENT DESCRIPTION
Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for *** self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with *** mission of Building Healthier Communities Together
EXPERIENCE/EDUCATION/QUALIFICATIONS
Associate's degree or equivalent experience required.
Two (2) years experience in Provider Services required.
Two (2) years experience in Health Plan Insurance Plans required.
Previous Facets experience required.
Previous claims experience preferred.
" Experience in provider data healthcare
" Provider data entry experience
" Experience in documenting processes, creating workflows and policies
" Knowledge of compliance requirements and procedures preferred
" Critical and analytical thinking skills
" Project implementation preferred
" Experience in Facets, or similar provider data or claims processing system
" Experience in other provider related healthcare departments such as credentialing, provider relations or contracting preferred
Position Urgency:
Normal
Shifts:
Days (0800-1700) no weekends
State License Details:
Not Needed
Minimum Years of Experience:
2
Minimum Guaranteed Hours:
No Guarantee
Specialty Type:
Clerical
Sub Specialty:
Medical Staff Coordinator, Data Quality Specialist
Bilingual:
No
EMR Used:
EPIC
Holiday Coverage Required:
No
DEPARTMENT DESCRIPTION
Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for *** self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with *** mission of Building Healthier Communities Together
EXPERIENCE/EDUCATION/QUALIFICATIONS
Associate's degree or equivalent experience required.
Two (2) years experience in Provider Services required.
Two (2) years experience in Health Plan Insurance Plans required.
Previous Facets experience required.
Previous claims experience preferred.
" Experience in provider data healthcare
" Provider data entry experience
" Experience in documenting processes, creating workflows and policies
" Knowledge of compliance requirements and procedures preferred
" Critical and analytical thinking skills
" Project implementation preferred
" Experience in Facets, or similar provider data or claims processing system
" Experience in other provider related healthcare departments such as credentialing, provider relations or contracting preferred
Position Urgency:
Normal
Shifts:
Days (0800-1700) no weekends
State License Details:
Not Needed
Minimum Years of Experience:
2
Minimum Guaranteed Hours:
No Guarantee
Specialty Type:
Clerical
Sub Specialty:
Medical Staff Coordinator, Data Quality Specialist
Bilingual:
No
EMR Used:
EPIC
Holiday Coverage Required:
No
Source : Tekfortune Inc.