CareLink Coordinator at University Health System- San Antonio – San Antonio, Texas

POSITION SUMMARY/RESPONSIBILITIES

Monitors and acquires daily and monthly CareLink data specifically for providers and members. This position is responsible for entering and maintaining provider data in the QNXT system, requiring a high level of accuracy, precision, and diligence to ensure the integrity of provider records support compliant claims processing. Plans and implements projects that will improve processes related to the maintenance of provider data, generating provider directories, claims entry/processing functions and enrollment data. Acts as an advisor and technical resource for provider reporting and processing to enable the department to meet CareLink objectives. Assists Manager in managing various research projects and reporting on member enrollment.

EDUCATION/EXPERIENCE

Associate degree in business, health care administration or related areas and/or an equivalent level of experience is preferred. Two years medical claims experience in health care setting is preferred. Knowledge of all claims coding formats, as well as insurance industry standard procedures required. Knowledge of QNXT claims and/or provider system recommended but not required.