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Provider Resolution Analyst I

Company: Horizon Blue Cross Blue Shield of New Jersey
Location: Newark
Posted on: January 16, 2020

Job Description:

job description is not designed to be an exhaustive list of all responsibilities, duties, and skills required of each incumbent.

Education/Experience:

* Requires a High School diploma or GED.

* Requires 2+ years claims experience.

* Facets experience preferred, but other claims experience considered

* CPT/HCPC and ICD9 coding, procedures and guidelines

Additional licensing, certifications, registrations:

* Requires knowledge of medical terminology. Strong Knowledge of Correct Coding Initiative, HCFA-1500 and UB-92 claim forms and CPT Coding

* Prefer knowledge of health care industry policies and procedures, knowledge of Medicaid or other Governmental Health Program.

* Prefers knowledge of FACETS or other Medicaid/commercial claims processing platform; knowledge of SharePoint system, Document Management System (DMS).

Knowledge:

* Requires knowledge of medical terminology. Strong Knowledge of Correct Coding Initiative, HCFA-1500 and UB-92 claim forms and CPT Coding

* Prefer knowledge of health care industry policies and procedures, knowledge of Medicaid or other Governmental Health Program.

* Prefers knowledge of FACETS or other Medicaid/commercial claims processing platform; knowledge of SharePoint system, Document Management System (DMS).

Skills and Abilities:

* Requires excellent presentation, oral and written communication skills.

* Requires customer service focus and a problem solving aptitude.

* Requires strong organizational and analytical skills.

* Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Outlook; should be knowledgeable in the use of intranet and internet applications.

* Ability to work as part of a team

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law.

Keywords: Horizon Blue Cross Blue Shield of New Jersey, Newark , Provider Resolution Analyst I, Professions , Newark, New Jersey

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