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Responsible for maintaining contracted and non-contracted provider profiles in Amisys to ensure correct setup for claims processing, capitation, line of business affiliations and contract intricacies for both clinic and practitioner level data. Works in conjunction with Pricing and Benefit Specialists as well as Provider Services and Credentialing to develop and implement provider contract configuration in Amisys.
Also responsible for maintaining membership subsystem in Amisys including employer group and individual set up for claims processing and billing. Works in conjunction with Benefit Specialists, Marketing, Enrollment and Underwriting to implement client profiles and premium building. Knowledge of Marketplace terminology and guidelines is preferred.