Data Associate

Job Description:

Support pilot product lines with sole responsibility for monitoring and evaluating the movement of providers across all Plan Partners and Participating Physician Groups (PPG's).

RESPONSIBILITIES:

- Provide support to the Provider Relations Department in maintaining an up to date Provider Database ensuring integrity in order to generate accurate Provider Directories for various product lines.
- Work in conjunction with Member Services to effectively coordinate member re-assignment upon termination of a Primary Care Provider (PCP).
- Provide assistance to the Claims Department to ensure timely processing of claims payment.
- Enter new contracts into the MHC System and make modifications to existing contracts.
- Also responsible for assisting in the collection, analysis, and evaluation of data in order to conduct complex studies through the use of statistical tools (eg chart, data graphs, and trend analysis) to prepare reports with graphic illustrations that draw conclusions based on findings.
- Other duties include generating required reports to be submitted to the Department of Managed Care (DMC), MRMIB and Geo Access.

SKILLS:

EDUCATION/EXPERIENCE:

- High School Diploma required.
- Bachelor of Arts/Science degree preferred.
- At least 3 years of healthcare related experience required.
- Knowledge of claims processing.
- Extensive knowledge of Microsoft Excel.
- Strong analytical skills.