For nearly 40 years, CoreSource has been delivering customized employee benefit administration services to self-funded employers across the United States.  Each CoreSource office around the country is managed locally by industry veterans who understand the dynamics of the markets in which they serve.  Every CoreSource office delivers the personal attention of a local Third Party Administrator, backed by the resources and innovation of a large national organization, The Trustmark Companies.

CoreSource is seeking a Network Integration Technical Analyst.  The Network Integration Technical Analyst is responsible for building and monitoring multiple functions within the Integrated Client Environment (ICE) in order to support both the Provider Network Integration team and the CoreSource organization as a whole.  This position requires analytical thinking and a proactive approach to identifying issues to minimize negative impact to the CoreSource business. #GD

KEY ACCOUNTABILITIES

Provider Network Maintenance and Support

• Strong understanding of network set up and claims routing with the ability to build and monitor routing rules and work queues.
• Ability to create ad hoc reporting to ensure processes and payments are functioning as expected.
• Strong understanding of EDI concepts, verbiage and terminology with the ability to read unedited EDI data.
• Strong understanding of claims class functionality and the ability to set up facility contracts using claims class.
• Interact with multiple departments within the organization for testing, troubleshooting and implementation of new network relationships and existing network modifications.
• Monitor EDI claims aging, research potential internal issues causing the aging and/or reach out to the network(s) involved to resolve issues.

Governance and Compliance

• Maintain compliance and consistent execution for Provider Network integration standards, governance and reporting requirements.
• Participate in network audits as necessary
• Maintain controls as required by the audit process

Provider Network Integration Team Participation

• Build good working relationships with the Provider Network Integration team
• Attend and contribute to weekly team meetings
• Provide suggestions for improvement and lessons learned from project team interaction
• Provider weekly status updates and alerts in a timely manner

Other duties as needed/assigned

MINIMUM EDUCATION AND EXPERIENCE REQUIREMENTS

• High School diploma or equivalent
• Minimum 4 years experience working in medical claims, provider maintenance or network support environments
• Understanding of EDI terminology and file structures
• Strong organizational, collaborative and interpersonal skills
• Strong troubleshooting and analytical skills
• Ability to read, understand and interpret network documentation
• Ability to work in a fast-paced customer service focused organization
• Ability to work effectively with team members, other departments, networks and clients
• Ability to effectively deal with problems and see through to resolution
• Excellent verbal and written communications skills
• Knowledge of FirstSTEPP preferred
• Knowledge of PowerSTEPP preferred
• Knowledge of medical terminology preferred
• SQL experience preferred
• .NET experience preferred
• A minimum of two years in the Integrated Client Environment (ICE) preferred

All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, age or disability.

Required Skills Required Experience

Candidates should be board-eligible or certified in Medical Genetics.

Boston University is an equal opportunity, affirmative action employer.  Women and minority candidates are strongly encouraged to apply.  The Department of Pediatrics believes that the cultural and social diversity of our faculty, staff, and students is vitally important to the distinction and excellence of our clinical, research and academic programs.

Academic rank and compensation will depend on qualifications and experience.  Interested candidates should email a statement of interest and current CV to the email address below.

JODI D. HOFFMAN, MD

DIRECTOR, DIVISION OF GENETICS

JODI.HOFFMAN@BMC.ORG

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law. We are a VEVRAA Federal Contractor.