Offers “Dxc Technology”

Expires soon Dxc Technology

Enrollment, Provider Associate Representative

  • Charleston (Kanawha)
  • Marketing

Job description


·  Job Description:

DXC Technology Operation jobs are responsible for the development and administration of our State health plan's operational departments, programs and services, in alignment with DXC Technology’s overall mission, core values, and strategic plan. To be in compliance with all relevant federal, state and local regulations.

Provider Enrollment Services staff are responsible for analyzing enrollment inquires and issues using data from internal and external sources to provide insight and make decisions for provider enrollment. Makes recommendations based on business data and market knowledge. Duties may include participating in management reviews, including presenting and interpreting analysis results, summarizing conclusions, and recommending a course of action. This is a general role in which employees work with multiple types of business data. Duties may be internal operations-focused or external client-focused, answering incoming call inquiries, the research and resolution of provider inquiries, and/or disputes concerning the enrollment process. They respond with the answer to all incoming inquiries and coordinate with other DXC Technology departments as needed to resolve the issue, ensuring that resolutions are timely and in compliance with all regulatory requirements.

Knowledge/Skills/Abilities

• Elicit requirements using document analysis, business process descriptions, use cases, business analysis, task and workflow analysis.
• Interpret customer business needs and translate them into application and operational requirements
• Communicate and collaborate with external and internal customers to analyze and transform needs, goals and transforming in to functional requirements and delivering the appropriate artifacts as needed.
• Work with the team within the business to provide recommendations on opportunities for process improvements..
• May actively participate in different stages of project development including research, design, programming, testing and implementation to ensure the released product meets the intended functional and operational requirements
• Resolves and provides a verbal or written response to incoming provider requests relating to their enrollment request and how that affects claim submissions.
• Completes appropriate documentation for tracking/trending data; reviews data to assist with identifying potential provider problem areas.
• Uses a variety of references to research and prepare healthcare provider information for loading into the health plan system/database; enters provider demographics, contract affiliation, or other data as needed.
• Interfaces with other departments regarding questions about provider configuration or other relevant provider issues.
• Maintains tracking system of correspondence and outcomes; maintains well-organized, accurate and complete files for all appeals.
• Monitors each request to ensure all internal and regulatory timelines are met.

Required Education

·  High School diploma or GED equivalent

Required Experience

·  1-2 years’ experience in a managed care or healthcare setting; data entry, and 10-Key experience preferred.
·  1-2 years’ experience with different types of provider license and certification requirements.
·  Required License, Certification, and Association: N/A
·  Preferred Education: Associate's Degree in Business and/or completion of a vocational program in Managed Care or some other health care aspect providing a certificate at completion preferred.
·  2-3 year’s healthcare experience, preferred
·  Preferred License, Certification, and Association: N/A, preferred

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