Care 1st Health Plan
Responsible for the integrity of provider records maintenance. Accurate and complete understanding of Contracts between Health Plan and Providers to configure into the system accordingly. Maintenance on Fee Schedules from Medicare and Medicaid for proper compensation . Ability to interpret and translate of Division of Financial responsibility matrix into standard medical codes. Perform system testing of contracts configuration to validate the set up produces an accurate result. Review and process provider updates to allow for UM Department activities.