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Horizon NJ Health

Not-for-profit health insurer offering medical plans

Provider Tech Support Analyst 2

Data ManagementPosted on Nov 4
Full-timeNewark, NJ, USA

About the Job

Requirements

  • A high school diploma or GED is required.
  • At least five years of relevant work experience in provider data management in healthcare or insurance is required.
  • A valid driver's license and access to an automobile are required.
  • A comprehensive understanding of healthcare is preferred.
  • An understanding of healthcare provider and claims systems is preferred.
  • An understanding of indemnity and managed care business and procedures is preferred.
  • Proficiency in personal computers and supporting software in a Windows-based environment, including Microsoft Office products (Word, Excel, and PowerPoint) and Outlook, is required; knowledge of intranet and internet applications is also expected.
  • Excellent attention to detail is required.
  • Excellent analytical abilities and the ability to report findings accurately are required.
  • Excellent oral and written communication skills are required.
  • The ability to interact with all levels of personnel and management is required.
  • The ability to organize and prioritize work assignments is required.
  • The ability to work independently and exercise sound business judgment is required.
  • The ability to understand medical terminology and medical procedures is preferred.

Responsibilities

  • Provide support to Network Data Management and departments that use provider data, including screening provider loading and coordinating procedural aspects related to Government Programs provider systems.
  • Assist with directing and supervising Provider File Area activities to ensure accurate, complete, and timely maintenance of Government Programs provider data files.
  • Resolve provider data errors by identifying causes, recommending improvements, identifying strengths, and documenting best practices.
  • Investigate incidents that affect data integrity and programs to support analysis of trends and potential vulnerabilities.
  • Assist in preparing, developing, and analyzing specifications for system enhancements and modifications to ensure provider files integrate with current and planned systems.
  • Produce and develop specifications and user-testing criteria, and secure appropriate documentation to assure accurate data in files.
  • Evaluate and recommend improvements to current operating procedures to enhance operating efficiency and controls.
  • Handle important or sensitive projects and priorities requiring a high degree of attention.
  • Produce departmental quality and production reports, including vendor audits.
  • Represent the department on workgroups and committees.

About the Company

Horizon NJ Health

Not-for-profit health insurer offering medical plans

Horizon NJ Health is a not-for-profit health insurer serving New Jersey. It offers a range of health insurance products for individuals, families, and employers, including medical plans such as HMOs and Medicare coverage for eligible people. The company collects premiums from its members and uses the funds to pay for member care through a network of doctors, hospitals, and healthcare providers. Any excess revenue is reinvested into the company to improve benefits and services for members, rather than distributing profits to shareholders. Horizon BCBSNJ holds a large market share in New Jersey and aims to provide access to comprehensive, affordable health coverage through a broad provider network. Its goal is to deliver reliable health insurance coverage and dependable care options that meet the needs of its members throughout the state.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Newark, NJ
Founded
1932

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