Provider Installation Analyst

At our company, our mission starts with our people. Guided by our HEART values-Humility, Excellence, Accountability, Respect, and Trust-we strive to create a workplace where teammates feel valued, supported, and empowered to do their best work every day. As a Provider Installation Analyst, you'll maintain accurate, up-to-date provider information using claims, provider databases, and reports. You'll ensure provider data meets business policies and state requirements, support system updates, and help improve the accuracy and efficiency of provider configuration processes.

Founded in 1996, Texas Children's Health Plan is the nation''s first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children''s Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children''s Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.

To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.

Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children''s without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Qualifications

• High school diploma or GED required; bachelor's degree preferred
• 2 years of experience in managed care, provider data configuration, and/or claims processing required
• Texas Medicaid experience preferred
• A bachelor's degree may substitute for the required work experience

Job Duties & Responsibilities

• Update provider information from reports, databases, and claims accurately and within departmental turnaround time and quality standards
• Maintain thorough, precise documentation of provider changes and issues for audit purposes
• Monitor pending claims and work queues and update the appropriate systems
• Escalate nonstandard data or data that does not meet business requirements, recommend improvements, and help implement changes to improve process accuracy and efficiency
• Identify claims affected by system configuration changes and send reports to Claims Administration for reprocessing
• Manage fluctuating workloads and prioritize assignments to meet deadlines and Health Plan needs
• Assist with training current staff and new hires as needed
• Participate in training related to system updates
• Review and test systems to ensure they meet functional and performance requirements
• Provide input on project implementation plans
• Help resolve defects in assigned business applications and communicate problems and resolutions to management
• Support and train internal users to promote consistent system knowledge and ownership

Job Duties & Responsibilities

• Update provider information from reports, databases, and claims accurately and within departmental turnaround time and quality standards
• Maintain thorough, precise documentation of provider changes and issues for audit purposes
• Monitor pending claims and work queues and update the appropriate systems
• Escalate nonstandard data or data that does not meet business requirements, recommend improvements, and help implement changes to improve process accuracy and efficiency
• Identify claims affected by system configuration changes and send reports to Claims Administration for reprocessing
• Manage fluctuating workloads and prioritize assignments to meet deadlines and Health Plan needs
• Assist with training current staff and new hires as needed
• Participate in training related to system updates
• Review and test systems to ensure they meet functional and performance requirements
• Provide input on project implementation plans
• Help resolve defects in assigned business applications and communicate problems and resolutions to management
• Support and train internal users to promote consistent system knowledge and ownership