Job Detail

Provider Network Analyst

Provider Network Analyst

Amerihealth

Charleston, SC

Job ID : 374f2f7156306c366c515a77394e653645773d3d

Job Description :

Job Brief

Work for one of South Carolina's Best Employers. This is a remote Healthcare Analyst position and you can live anywhere in the state of South Carolina.

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

Responsible for facilitating or performing root cause analysis and/or the development of reports, studies and data models related to monitoring the accuracy of benefit interpretation, claim payment, provider contract configuration, eligibility processing and revenue generating interfaces for lines of business. Defines and/or implements data modeling tools or reports designed to routinely assess existing operations processes including but not limited to benefit interpretation, claim payment accuracy systems interfaces and integration.

Education/Experience:

  • High School Diploma/GED required.
  • Bachelor’s Degree or equivalent education and experience preferred.
  • 3-5 years healthcare claims experience preferred.
  • Report writing, data analysis, data research in managed care operations preferred.
  • Proficiency with Microsoft Office Suite (Word, Excel, Power Point). Access is a plus.
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Company Details :

Name : Amerihealth

CEO : Paul Tufano

Headquarter : Philadelphia, PA

Revenue : $5 to $10 billion (USD)

Size : 5001 to 10000 Employees

Type : Company - Private

Primary Industry : Insurance Carriers

Sector Name : Insurance

Year Founded : 1983

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Details

: Charleston, SC

: 44262 - 65695 USD ANNUAL

: Today

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