[Hiring] Provider Tech Support Analyst II @Horizon Blue Cross Blue Shield of New Jersey

Role Description

This position is accountable for providing support to Network Data Management and all departments utilizing provider data, including the screening of provider loading, as well as coordinating all procedural aspects relative to the Government Programs provider systems. This position is also responsible for handling important or sensitive projects and priorities that require a high degree of attention and performing other duties as assigned by management.

What You'll Do

• Assist with the direction and supervision activities of the Provider File Area to ensure the accurate, complete, and timely maintenance of the Government Programs provider data files.
• Resolve provider data errors by identifying causation and recommend improvements, identifying strengths and documenting best practices.
• Investigate all incidents impacting the data integrity and programs to allow for analysis of trends and potential vulnerability.
• Assist in the preparation, development, and analysis of specifications for system enhancements and modifications to ensure provider files integrate properly with current and planned systems.
• Produce and develop specifications and user testing criteria while securing appropriate documentation to assure accurate data in file.
• Evaluate and recommend improvements to specific current operating procedures to enhance operating efficiencies and controls.
• Handle important or sensitive projects and priorities that require a high degree of attention.
• Produce departmental reporting for quality and production, including vendor audits.
• Provide departmental representation on workgroups and committees.

Qualifications

• High School Diploma/GED required.
• Minimum of 5 years relevant work experience in provider data management in Healthcare/insurance is required.

Requirements

• Knowledge of healthcare provider systems and claims processing systems.
• Understanding of managed care and indemnity business models and operations.
• Familiarity with provider credentialing processes, provider data integration, system enhancement projects, and testing methodologies.
• Knowledge of medical terminology and healthcare procedures.
• Experience supporting vendor audits, compliance activities, or operational reporting.
• Use of AI tools to support operational efficiency.
• Proficient in the use of personal computers and supporting software in a Windows-based environment, including MS Office products (Word, Excel, PowerPoint) and Outlook.
• Excellent attention to detail.
• Excellent analytical abilities and the ability to report findings accurately.
• Excellent oral and written communication skills.
• Ability to interact with all levels of personnel and management.
• Ability to organize and prioritize work assignments.
• Ability to work independently and exercise sound business judgment.
• Prefer the ability to understand medical terminology and medical procedures.

Benefits

• Comprehensive health benefits (Medical/Dental/Vision)
• Retirement Plans
• Generous PTO
• Incentive Plans
• Wellness Programs
• Paid Volunteer Time Off
• Tuition Reimbursement

Salary Range

$63,000 - $84,420

This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case.