Provider Demographics Database Specialist
BlueCross BlueShield of Kansas City - Kansas City, MO

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Mission Statement

"We will use our role as the area’s leading health insurer to provide affordable access to healthcare and to improve the health and wellness of our members."

Job Description

Summary of Position:
Maintains provider information in the Facets provider database.

Essential Accountabilities – Other duties may be assigned:
* Maintains in-area and out-of-area provider demographic information in Facets.
* Responds to provider demographic inquiries from the Operations area..
* Facilitates completion of external and internal audits relative to provider demographics.
* Prepares documents for Imaging and retrieves documents from AWD.
* Maintains Provider Services central files area.
* Sorts and distributes mail, retrieves faxes and distributes and ensures all supplies are available and ready for use in the Mail Room.
* Researches return mail for provider demographic updates in Facets.
* Works daily QA reports when received.

Principal Challenges – List the most typical and/or most complex problems or challenges faced in performing the job:
* Acquiring the knowledge to complete provider updates in Facets using the electronic puf (Provider Update Form).
* Acquiring the knowledge to prepare, route and complete documents using AWD, our imaging system.
* Understanding the sensitive nature of the provider contract files.
* Understanding the importance of obtaining current, accurate address information for provider return mail.

Supervisory Responsibilities (if applicable):
None

Qualifications – The following qualifications are representative of the basic knowledge, skills and abilities required to perform this job at a satisfactory level. Reasonable accommodations may need to be made to enable individuals with disabilities to perform the essential functions:

Abilities:

Reading
* Ability to read and interpret documents such as safety rules, operating instructions, handbooks and procedure manuals.
Writing
* Ability to write simple sentences, paragraphs and correspondence.
Speaking
* Ability to effectively present information in one-on-one and small group situations to customers, clients and other employees of the organization.
Mathematical
* Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions and decimals.
Reasoning
* Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form.
* Ability to deal with problems involving several concrete variables in routine, standard situations.
Other (please specify)

Knowledge and Skills:
* Advanced keyboarding skills.
* Intermediate knowledge of Microsoft Windows.
* Intermediate knowledge and skill with Microsoft Office applications, or similar PC-based software.
* Beginner level knowledge of Facets and Outlook.
* Beginner level knowledge of AWD Imaging program.

Education and Years of Experience:
High school diploma or equivalent and 2-3 years of general office and clerical experience, with at least 3 months experience in database update and maintenance preferred; or any combination of education and experience providing the types and levels of knowledge, skills, and abilities required by the job.

Certification, Licenses, Registrations Required:
None

Physical Demands – The physical demands listed are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.:
Position is mostly sedentary with occasional standing, walking, reaching, climbing, balancing, stooping or kneeling. May be required to lift up to 10 pounds on an infrequent basis. Will also be required to use fingers, hands, and arms for keyboarding. Ability to speak and hear clearly is required for giving and receiving information. Both close and distance vision are necessary.

Work Environment - Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.:
Work is performed in an environmentally-controlled office setting, with no exposure to adverse conditions.

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