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Provider Specialist (Remote) at Health Care Service Corporation - ApplyBlast

Provider Specialist (Remote)

Health Care Service Corporation

4 months ago

3.8 on Glassdoor

Albuquerque, NM

Onsite

Full Time

Junior

0 applicants

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About this role

This role involves loading providers into the IHSCPS system to understand Medicare Services reimbursement at a national level for various services. Key duties include interpreting Indian Health Services contract language to create pricing, verifying billing protocols, and resolving complex payment disputes. The position requires acting as a subject matter expert for provider and pricing files while supporting system testing and implementation.

Responsibilities

Load providers into IHSCPS system for Medicare reimbursement
Interpret Indian Health Services contract language for pricing
Resolve complex payment disputes and pricing problems
Conduct 100% quality reviews on new contracts
Train new provider payment specialists on file tasks

Skills

Qualifications

High school diploma or equivalent

About Health Care Service Corporation

hcsc.com

Headquarters

Chicago, Illinois, United States

Company Size

10001+ employees

Founded

1936

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Health Care Service Corporation (HCSC) is a mutual legal reserve company and trusted partner in health, offering health insurance plans across Illinois, Montana, New Mexico, Oklahoma, and Texas. With nearly a century of experience, HCSC serves over 27 million people through a portfolio of health benefit solutions designed to deliver access to quality, cost-effective care. The company drives innovations to improve health outcomes and reduce costs for its members, employees, and communities.