Business Specialist

  • AmeriHealth New Jersey
  • Cranbury, NJ, USA
  • Jun 29, 2020
Full time Entry Level Health Care Insurance

Job Description

The successful person in this role will:

  • Assist with producing network data reports related to physician network additions, terminations, and general attrition; ad hoc reports related to network access/adequacy, availability, size and composition, including Geo Access analysis, network adequacy, general network disruptions, and support of accreditation activities.
  • Maintain tracking database for the variety of reports to ensure all requests are logged properly and tracked to ensure agreed upon turnaround times are met.
  • Provide administrative and analytical support for Annual Supplement for NJ DOH, Head and Access report, and network trend analysis using a variety of databases from internal and external sources.
  • Support department in fulfilling general Provider data requests (demographics, mailing files, provider termination analysis).
  • Assist the Business Analysts with data preparation including data review/formatting and preparing presentations of said data.
  • Provide organizational support to network ops team including but not limited to operations dashboard maintenance, mass claims adjustment project tracking, track Single Case Agreement data, maintain contract calendar, and other various tracking tools.

Qualifications:

  • Associate degree required
  • Bachelor’s Degree preferred
  • 1-2 years working with healthcare provider related data
  • Excellent oral and written communication skills
  • Able to follow detailed policies and procedures.
  • Must have the ability to work independently and within a team environment.
  • Skills in MS Office applications and data management including, but not limited to, Excel, Word, and Access required