- Homewood, IL, USA
- Full Time
Medical, Dental, Vision, 401(k), Life, Optional Life, AD &D, STD, LTC, LTD, Wellness, Vacation, PTO, Holiday,
HealthComp Holding is one of the top 5 national independent third party administrators (TPAs) in the country. Serving over 360,000 members, we are private-equity backed, investing heavily in the business and growing much faster than the industry. Benefit Administrative Systems (BAS) is an operating division within HealthComp Holdings. Along with medical, dental, vision, COBRA and HIPAA administration, we also provide integrated solutions for flexible benefit plans and health and wellness management. We have a proven track record managing health care costs and delivering an unparalleled member experience. In addition, our in-house operations provide superior flexibility, customization and data access.
The Provider Maintenance Specialist is primary responsibility is to ensure provider data in the QicLink (QL) system is as accurate as possible and match inbound claims with the correct provider record.
This includes but is not limited to:
- Reviewing / modifying the daily provider load files.
- Exporting the load file and loading into QL.
- Matching providers on incoming claims that fail to match programmatically.
- Add / update PCP selections for Intel members in QL.
- Maintain the master PCR list and hook up new providers to the correct PCR in QL.
- Work provider mail returned for invalid address.
- Handle all provider documents in regard to the 1099-year end reporting process. (W9, B notices)
- Understand the department filing system, file all documents accordingly, and be able to pull documents when requested for audit.
The role will work side-by-side with the Team Supervisor, Customer Service, Claims Management, Claims Examiners on a daily basis and external providers as needed.