Prov Installation Analyst

About Texas Children's Hospital

Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S.News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years.

Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, a second community hospital opening in 2017. We have also created the nation’s first HMO for children, established the largest pediatric primary care network in the country and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is also academically affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation.

To join our community of 13,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.

Summary:

We’re looking for a Provider Installation Analyst, someone who’s ready to grow with our company. This position is responsible for accurate and timely maintenance of provider information from claims and Provider databases/reports. Validate that provider information entered on databases adheres to business policies and State requirements. 

Job Duties & Responsibilities 

• Performs provider configuration in adherence to business rules. 
• Updates provider information as reviewed via a report/database or directly from a claim in an accurate and timely manner to meet the department’s standards of turnaround time and quality. 
• Maintains thorough and precise documentation for tracking all provider changes and/or issues for audit purposes. 
• Monitors pended claims and work queues to update appropriate systems. Responsible for escalating non-standard data or data that does not meet the Business requirements, making recommendations and assisting with implementing changes to improve accuracy and efficiency of processes. 
• Identifies claims impacted by configuration changes done in the system and sends reports to the claims administration department for reprocessing. 
• Handles fluctuating volumes of work and prioritizes work to meet deadlines and needs of the Health Plan. 
• Assists in training current staff and new hires, as necessary. 
• Supports implementation and upgrades of systems. 

Skills & Requirements 

• Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children’s unless approved for a medical or religious exemption 
• Required H.S. Diploma or GED with a preferred bachelor's degree 
• Required 2 years Managed care, provider data configuration, and/or claims processing with preferred TX Medicaid experience 
• A bachelor's degree may substitute for the required work experience. 

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