Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:
Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
Onsite: daily onsite requirement based on the essential functions of the job
Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building
Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.
This position is hybrid within the state of AZ only. This hybrid work opportunity requires residency, and work to be performed, within the State of Arizona.
PURPOSE OF THE JOB
This position supports the Network Contracting department by completing tasks that ensure delivery of timelines and high standard are met for a highly functioning contracting department. This includes a variety of assigned tasks as well as projects assigned by management.
QUALIFICATIONS
REQUIRED QUALIFICATIONS
Required Work Experience
1 year of office experience, including customer service
Required Education
High-School Diploma or GED in general field of study
Required Licenses
N/A
Required Certifications
N/A
PREFERRED QUALIFICATIONS
Preferred Work Experience
N/A
Preferred Education
N/A
Preferred Licenses
N/A
Preferred Certifications
N/A
ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES
Assembles, reviews and coordinates required documents and information pertaining to contracting requests, projects, management of contracts and related areas.
Obtains and verifies required documentation from existing and potential providers, as required for contracts and credentialing.
Manages Departmental email boxes utilized by internal and external customers for request submissions, status updates, etc.
Manages incoming fax requests from provider offices.
Understands terminology and the processes and policies encountered in contracts for Medicaid and Medicare business requirements.
Composes drafts of letters and documents related to the preparation of contract documents.
Manages the tracking process of all incoming & updated information pertaining to contract requests or data updates, including assigning to the appropriate contract specialist or network operations representative.
Develops and maintains accurate records.
Resolves problems and makes decisions in accordance with departmental policies and procedures
Maintain databases; collect, track, prepare, compile, and distributes statistical data, as required.
Provides statistical reports and maintains records of request for qualifying healthcare professionals for all product services offered by Medicaid Business Segment Products.
Provide support to contract specialist to ensure successful completion of contracting process, including loading and system verification.
Identify gaps by network analysis and risk in contracting process and coordinate with multiple departments to ensure contracting process is completed timely and accurately and within required established standards and guidelines set by Regulators and HC policies.
Navigate effectively through the system of record to ensure all information within all documents are verified in a timely manner.
Perform all other duties as assigned
The position has an onsite expectation of 1 day per week and requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
COMPETENCIES
REQUIRED COMPETENCIES
Required Job Skills
Understanding of provider networks, including provider specialties and hospitals
Understanding of ICD10, CPT, HCPC, Revenue Codes
Required Professional Competencies
N/A
Required Leadership Experience and Competencies
N/A
PREFERRED COMPETENCIES
Preferred Job Skills
N/A
Preferred Professional Competencies
N/A
Preferred Leadership Experience and Competencies
N/A
Our Commitment
AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.
Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.
Skills Required
- 1 year of office experience, including customer service
- High-School Diploma or GED
- Understanding of provider networks, including provider specialties and hospitals
- Familiarity with ICD10, CPT, HCPC, and Revenue Codes
- Must reside in Arizona and be able to work hybrid with onsite presence at least once per week; full-time (40 hours/week)
What We Do
Blue Cross Blue Shield of Arizona is a non-profit health insurance company dedicated to improving the health of Arizonans by providing insurance plans and related services.
