Provider Configuration & Contract Analyst

Primary Purpose:

Responsible for providing general configuration and business analytical support to the IS Department.

Principal Duties and Responsibilities (* = essential functions):

• Responsible for the accurate entry and configuration of new providers and updates to existing providers in the primary processing application. *
• Assist with troubleshooting issues and testing up updates related to MedMC and other applications used by PDT staff, maintained by the IS Department.
• Responsible for the processing of reports via MedMC, Excel, Access, and/or Other Reporting applications. *
• Provide cross-coverage and support to other IS staff.
• Other duties as assigned.

Job Specifications (KSAs):

• Must work well both independently and in a team setting.
• Requires ability to perform a variety of complex tasks requiring the exercise of independent judgment.
• Requires strong attention to detail and the ability to stay focused while working on a project.
• Must be able to work on several projects at a time.
• Must be extremely proficient with Microsoft Office applications, including Excel and Access
• Requires the ability to speak, read, write, and understand English and other general educational skills as is generally obtained by completing high school or a GED.
• Requires the ability to read and understand provider contracts and health plan benefit documents.
• Requires a basic understanding of medical terms, practices, and coding (CPT, HCPCs, ICD-9, Revenue, etc).

Position Performance Criteria:

1. Consistently produces accurate and timely work as it relates to departmental goals.
2. Demonstrates high reliability through consistent punctuality and attendance.
3. Competently performs position requirements with minimal supervision and direction, including taking initiative and assuming responsibility for follow-through.
4. Uses sound judgment about time management and prioritization of work to balance multiple tasks and meet required timeframes for all administrative activities as required.
5. Demonstrates excellent interpersonal skills as discerned through observation and team project successes.
6. Accurately interprets and applies departmental policies and procedures using sound judgment.
7. Communicates, professionally, and respectfully to peers, superiors, subordinates, and clients.
8. Provides constructive feedback on work projects assigned.
9. Demonstrates overall professionalism in attitude, demeanor, and personal appearance

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee is regularly required to sit and use hands to finger, handle, or feel. The employee is frequently required to reach with hands and arms and to talk or hear. The employee is occasionally required to stand; walk; climb or balance and stoop kneel crouch or crawl. The employee must regularly lift and/or move up to 10 pounds and occasionally lift and /or move up to 25 pounds.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. The noise level in the work environment is usually moderate.