Network Data Coordinator

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

• Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

• Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

• Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

The Provider Network Data Coordinator is responsible for accurate and timely data entry of provider information (delegated and non-delegated) into the CACTUS database in accordance with departmental policies and procedures. Maintains current provider data as received from Providers via CHCs website, ticket system, or from other departments within CHC to ensure the quality of the network. Confirms the accuracy of provider identification numbers including Tax Identification Number (TIN), National Provider Identifier (NPI), and the Texas Provider Identifier (TPI) when feasible. Initiates database process improvements and assist in utilizing exception reports to improve quality metrics. Performs document scanning functions for the Network Management Department. Prepares the Provider Database for directory production. Assists with departmental special projects as it relates to Provider Database maintenance.

QUALIFICATIONS:

• Associates Degree or two years of college preferred. Equivalent work experience may be substituted.
• Three years of administrative experience working with databases in a claims or managed health care setting, proficiency with Microsoft Word, Excel, and Access preferred.

Other Skills:

• Above Average Verbal communication skils
• Writing /Composing/ Correspondence/Reports
• Analytical, Mathematics, Medical Terms, Statistical
• MS Word, MS Excel,
• MS Access
• Diligent, accurate data entry, well organized, attention to detail.
• Familiarity with medical coding.

Community employees’ benefits are provided by Harris Health. These benefits are designed to provide you with flexibility and choices in meeting your specific needs.

Community is an Equal Opportunity Employer.

Clerical and Administrative Support