Reimbursement Implementation Specialist II

  • Synchronizes data on claims and provider databases and provides expertise on business requirements for multiple business regions.
  • Identifies, analyzes, and resolves issues for multiple system provider databases.
  • Participates in system testing and analysis in support of new functionality, new system processes, and business rules changes.
  • Validates the data to be housed on provider databases and ensures adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing. Researches and resolves complex exceptions and error reports.
  • Determines regional/cap/business indicators for multiple business areas to assure accurate reimbursement based on provider contract and area fee schedules.
  • Determines training needs and provides training to less experienced associates and outside customers on multiple provider data base systems and with multiple business requirements. 

Minimum Requirements 

  • H.S. diploma
  • Minimum of 3 years provider database experience; or any combination of education and experience, which would provide an equivalent background.