Provider Network File Technician I-III

Job not on LinkedIn

🔥 0 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

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👻 Ghost score 10%

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Blue Cross Blue Shield of Arizona

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1939

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Blue Cross Blue Shield of Arizona is a health insurance provider offering a variety of health plans tailored to individuals, families, employers, and Medicare recipients. With a commitment to improving healthcare access and community health, AZ Blue provides self-insured and ACA-compliant health plans, including Medicare Advantage and Medicaid options. The organization focuses on connecting members with care through its extensive network, aiming for better health outcomes and community support.

📋 Description

• Update and maintain applicable provider file databases with submitted documentation • Research provider contract files and recommend appropriate actions and/or maintenance • Research and resolve provider file claims edits • Analyze reports for data corrections and processes for the Association • Review provider files for Quality Control • Perform essential functions of lower levels as responsibilities progress • Work at least 40 hours per week, plus additional hours as requested or needed to meet business requirements • Perform all other duties as assigned

🎯 Requirements

• 1 year of experience in general business field (level 1) • 3 years of experience in general business field (level 2) • 5 years of experience in general business field (levels 3 and 4) • High-School Diploma or GED in general field of study • Intermediate PC proficiency • Intermediate skill in use of office equipment, including copiers, fax machines, scanners and telephones • Intermediate level skill in word processing, spreadsheet and database software • Ability to maintain confidentiality and privacy • Ability to interpret and translate policies, procedures and guidelines • Ability to follow and accept instruction and direction • Ability to establish and maintain working relationships in a collaborative team environment • Ability to navigate, gather, input and maintain data records in multiple system applications with applicable accuracy • Ability to work independently (levels 2–4) • Ability to problem solve (levels 2–4) • Ability to provide fair and accurate quality reviews (levels 3–4) • Ability to handle projects with minimal supervision (levels 3–4) • Ability to handle high volumes of work with additional responsibility for cross-functional duties (level 4) • Ability to make decisions related to provider file processes and explain information clearly (levels 3–4) • Ability to train, mentor and guide co-workers (levels 3–4) • Ability to distribute work to lower levels (level 4) • Ability to handle escalated/expedited issues to resolution (level 4) • Ability to interpret and make decisions based on available reporting (level 4) • Ability to cover for Management when needed and represent the department (level 4) • Associate's Degree in general field of study (preferred) • 2 years of experience in health insurance field (preferred)

🏖️ Benefits

• Hybrid workforce strategy called Workability offering flexibility with how and where employees work • Remote work opportunity • Health insurance products and services • Information and tools to help individuals make better health decisions