Job Description
**Role Overview:** The Senior Provider Network Operations Analyst responsible for maintaining current provider data and provider reimbursement setup, and to address provider and state inquiries as they relate to claim payment issues.
**Work Arrangement:**
+ Hybrid – The associate must be in the office at least three (3) days per week at our Manchester, New Hampshire (NH) location.
**Responsibilities:**
+ Review/approves and audits Payment Integrity (PI) vendor and internal prospective and retrospective edits/projects/recoveries
+ User Acceptance Testing (UAT)/Client Review & audit (provider data, Appian Advanced Group ID (AGID) configuration, and set-up concentration) reviews requests prior to initial submission to Enterprise Operations (EO) and claims post-production
+ Facets claims edit configuration concentration (Appian) – intake, review, impact assessment, and initial submission; UAT reviews requests prior to initial submission to EO and ...
**Work Arrangement:**
+ Hybrid – The associate must be in the office at least three (3) days per week at our Manchester, New Hampshire (NH) location.
**Responsibilities:**
+ Review/approves and audits Payment Integrity (PI) vendor and internal prospective and retrospective edits/projects/recoveries
+ User Acceptance Testing (UAT)/Client Review & audit (provider data, Appian Advanced Group ID (AGID) configuration, and set-up concentration) reviews requests prior to initial submission to Enterprise Operations (EO) and claims post-production
+ Facets claims edit configuration concentration (Appian) – intake, review, impact assessment, and initial submission; UAT reviews requests prior to initial submission to EO and ...