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Provider Relations Specialist

Date Posted:  Jun 24, 2022
Requisition ID:  329302
Location: 

Indianapolis, IN, US, 46204

 

Work for Indiana

Grow your career with the State of Indiana! With more than 50 executive branch agencies, the State of Indiana is a diverse workforce offering employees stimulating and challenging projects across a broad scope of career opportunities. As a State of Indiana employee, you impact the well-being of Indiana’s communities every day.

 

At the State of Indiana, we don’t just talk about diversity and inclusion – Our goal is to create a welcoming, accessible, and equitable workplace, with a workforce that is representative of the State of Indiana population. We are proud to be an equal opportunity employer.

 

About the Indiana Department of Health:
TThe Indiana Department of Health’s mission is to promote and provide essential public health services for a healthier and safer state. 
 
Salary Information:

This position traditionally starts at an annual salary of $28,366.00 annually but may be commensurate with education and job experience.
 

About the Job:

The purpose of this position is to ensure timely enrollment and maintaince of of providers on the CSHCS program through provider enrollment activities, data file updates, and problem resolution.

A Day in the Life:

The essential functions of this role are as follows:

  • Performs a wide variety of operational support activities related to provider enrollment activities, including but not limited to:  working with the Auditor's Office to set up direct deposit, data entry, and management of the ACAPS provider relations information.  
  • Answers calls from service providers and provides technical assistance as requested or triages calls as appropriate.  Investigates provider issues related to claim payment and follows up with providers to ensure issues are resolved.  Provides technical assistance to other sections within the program on provider issues.
  • Updates and makes notes in the provider file about provider problems and/or concerns so that members can easily access information related to claims status and participant eligibility.  Develops  a follow-up system to keep track of provider agreements mailed out and returned. Serves as a liaison between providers and the Auditor's Office ensuring the provider are set up correctly for claims payments and updats the information as necessary.
  • Assists with activities necessary to update and maintain the provider database to meet the requirements for accurate claims payment.
  • Assists providers in resolving and educating providers on the importance of keeping all information current to facilitate timely claims payments.
  • Knowledge of the National Plan and Provider Enumeration System (NEPPES) and ability to assist providers in getting set up with NEPPES with NPI numbers that will result in correct payment of their claims. 
  • Assist providers with obtaining Web Portal access in order to view online claim status information.  Also provides education to providers regarding the necessity of keeping NPI, tax identifications, and addresses updated to facilitate accurate claims payment.
  • Troubleshoot with the Finance Division and Auditor of State (AOS) any questions and/or problems related to provider financial or location information. 
  • Coordinate with the CSHCS IT Team to test any new ACAPS, Web Portal, or other system enhancements through verifying system validations are appropriately in place for processing claims and entering and processing test cases to ensure optimal system functioning. 
  • Ensure compliance with all HIPAA policies and guidelines.

The job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time.

Reasonable accommodations may be made to enable individuals with disabilities to interview and to perform the essential functions of this role.

What You'll Need for Success:

  • This role will have knowledge and ability to navigate through ACAPS (Agency Claims Administration and Processing System) and the Family Social Services Adminstration (FSSA) Core MMIS systems to find and locate information on an individual case basis.  
  • Must have excellent phone communication skills.  
  • Will have the ability to:  meet deadlines, work claims in a first-in/first-out philosophy, handle light filing, and accept and complete other duties as assigned.
  • Knowledge of the Children's Special Health Care Services (CSHCS) Program policies and procedures. Working knowledge of the ACAPS System and database management skills. Knowledge of the Auditor's Office polices and procedures with regard to direct deposit and issues related to claims payment and it relates to the need for correct and updated information via the Vendor Information Form.
  • Ability to draft and prepare correspondence and reports a technical and specialized nature.

 

Benefits of Employment with the State of Indiana:

The State of Indiana offers a comprehensive benefit package for full-time employees which includes: 

  • Three (3) medical plan options (including RX coverage) and vision/dental coverages 
  • Wellness program (offers premiums discount for the medical plan) 
  • Health savings account (includes bi-weekly state contribution) 
  • Deferred compensation account (similar to 401k plan) with employer match 
  • Two (2) fully-funded pension plan options 
  • Group life insurance 
  • Employee assistance program that allows for covered behavioral health visits 
  • Paid vacation, personal and sick time off 
  • Competitive leave policies covering a variety of employee needs 
  • 12 company paid holidays, 14 on election years 
  • Qualified employer for the Public Service Loan Forgiveness Program 
  • New Parent Leave 
  • Free Parking 
  • Free LinkedIn Learning 

 

Equal Employment Opportunity:

The State of Indiana is an Equal Opportunity Employer.

 

Current Employee? Click here to apply.


Nearest Major Market: Indianapolis