Provider Data & System Configuration Analyst

Texas Children's; Bellaire (TX); On-site; USD 55,000 - 85,000; Full time

Job summary

Texas Children's seeks a Provider Installation Analyst to maintain accurate provider information using claims, provider databases, and reports. You will ensure data meets policy and state requirements, support system updates, and improve provider configuration efficiency.

Responsibilities include updating provider data, documenting changes for audits, monitoring claims, and escalating nonstandard data while implementing process improvements to meet Health Plan needs.

Qualifications

• High school diploma or GED required; bachelor's degree preferred.
• 2 years of experience in managed care, provider data configuration, and/or claims processing.
• Texas Medicaid experience preferred.
• A bachelor's degree may substitute for the required work experience.

Responsibilities

• Update provider information from reports, databases, and claims accurately and within departmental turnaround time and quality standards.
• Maintain thorough, precise documentation of provider changes and issues for audit purposes.
• Monitor pending claims and work queues and update the appropriate systems.
• Escalate nonstandard data or data that does not meet business requirements, recommend improvements, and help implement changes to improve process accuracy and efficiency.
• Identify claims affected by system configuration changes and send reports to Claims Administration for reprocessing.
• Manage fluctuating workloads and prioritize assignments to meet deadlines and Health Plan needs.
• Assist with training current staff and new hires as needed.
• Participate in training related to system updates.
• Review and test systems to ensure they meet functional and performance requirements.
• Provide input on project implementation plans.
• Help resolve defects in assigned business applications and communicate problems and resolutions to management.
• Support and train internal users to promote consistent system knowledge and ownership.

Education

High school diploma or GED required

Bachelor's degree preferred

Job description

Texas Children's seeks a Provider Installation Analyst to maintain accurate provider information using claims, provider databases, and reports. You will ensure data meets policy and state requirements, support system updates, and improve provider configuration efficiency.

Responsibilities include updating provider data, documenting changes for audits, monitoring claims, and escalating nonstandard data while implementing process improvements to meet Health Plan needs.