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Provider File Maintenance Specialist in Boston, MA at Beacon Health Options

Date Posted: 1/6/2019

Job Snapshot

Job Description


The Provider File Maintenance Specialist will provide business and system support for multiple functions within Network Connect. Evaluate and modify Provider database systems' requests; and maintain business operations for new and existing Providers. Create provider files for all Out of Network Providers and Single Case Agreements

Position Responsibilities:

  • Create and implement electronic files for all Providers in Network Connect for all Out of Network Providers and Single Case Agreements
  • Review Service Connect for all inquiries pertaining to Out of Network Providers and Single Case Agreements and code accordingly.
  • Ensure accurate data entry of all information entered from Service Connect Inquiries into-o Ne t work Connect
  • Update changes to the Provider agreements/contracts in Network Connect, including demographics, rates, services for all Out of Network Providers and Single Case Agreements.
  • Create new contracts and rate sheets for new and existing Providers in Network Connect
  • Assist senior Provider File Maintenance Specialist all aspects of rate implementations, provider demographic updates, service code updates, fee codes.
  • Assist of building letter module s, exhibit A (contract) modules, reporting modules, participation agreements,
  • Assist Credentialing Specialists creating provider files for new practitioners
  • Assist in special projects; Example but not limited to. Rate Changes, Contract deliverables, printing contracts, System upgrades, etc.

Position Requirements:

  • Education: Bachelor's Degree in a Human Services field or similar field preferred. Or, at least five years related experience in a behavioral health or managed care environment preferred.
  • Relevant Work Experience: Minimum of three years’ experience in the insurance or finance industry (or appropriate education), with one year of healthcare experience preferred.

To Apply:

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Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.  EOE/AA/M/F/Veterans/Disabled