GEHA (Government Employees Health Association, Inc., pronounced G.E.H.A.) is a nonprofit member association that provides medical and dental benefits to more than two million federal employees and retirees, military retirees and their families. We celebrate diversity and are committed to creating an inclusive environment for all employees.
GEHA has one mission: To empower federal workers to be healthy and well.
Offering one of the largest medical and dental benefit provider networks available to federal employees in the United States, GEHA empowers health and wellness by meeting its members where they are, when they need care. We serve our members with products they value and a personalized customer experience, sustained by a nimble and efficient organization.
Reviews Provider Records maintained by Tech I. Ensures their eligibility in accordance with network, client and government regulatory guidelines. Ensure accurate updates and maintains provider records within our claims payment systems. Works under general supervision and may provide guidance to lower levels.SKILLS
Performs analysis and completes entry into Salesforce for all provider applications and updates including adds, changes, and terminations. Occasionally assists with audit of network provider entry into Facets to ensure accuracy and the integrity of the network provider data. Completes phone verification calls to providers to obtain missing data elements for credentialing and updates as defined by state regulations. Performs routine assignments with minimal supervision.
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Reviews contracted provider data and completes entry into the Salesforce system.
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Verifies provider’s group affiliations.
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Occasionally utilizes NPPES NPI Registry to verify provider NPI and update per NPI website.
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Identifies updates of provider specialty, education, American Board Certification, and state license number and forwards to Credentialing for verification.
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Contacts provider to obtain required data elements to complete provider updates.
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Assists Contract Administrator with maintaining updates to the job aides, makes recommendations for process updates, and maintains updates to the job aides based on recommendations from the Contract Administrator.
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Assists with audit of applications, adds, changes, and terms into the Salesforce and Facets systems and completes audit spreadsheets and provides feed back to the Contract Administrator.
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Reviews and updates error reports received from payers as needed.
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Provides weekly status reports to Contract Administrator to be used for reporting to Supervisor, Provider Relations, and PPO USA.
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Assists with completing provider entry for all applications, adds, changes, and terminations.
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Assists with other tasks as assigned.
REQUIREMENTS: Education & Experience
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Requires high school diploma or equivalent
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Requires three years of data entry or similar clerical experience
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Requires effective written and verbal communications skills to answer questions from staff and respond to inquiries
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Requires alpha numeric entry of 10,000 KPH
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Requires analytic ability to prepare departmental reports and ability to compare data and resolve discrepancies
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Requires proficiency with Word and Excel
Preferred: Salesforce experience
Work-at-home requirements
- Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.
- A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.
- Latency (ping) response time lower than 80 ms
- Hotspots, satellite and wireless internet service is NOT allowed for this role.
- A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
How we value you
- Competitive pay/salary ranges
- Incentive plan
- Health/Vision/Dental benefits effective day one
- 401(k) retirement plan: company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution
- Robust employee well-being program
- Paid Time Off
- Personal Community Enrichment Time
- Company-provided Basic Life and AD&D
- Company-provided Short-Term & Long-Term Disability
- Tuition Assistance Program
Please note that the salary information is a general guideline only. GEHA considers factors such as (but not limited to) scope and responsibilities of the position, candidate’s work experience, education/training, key skills, internal peer equity, as well as, market and business considerations when extending an offer.
The annual base salary range for this position is $44,574 - $62,834 USD.
GEHA is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. GEHA will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees. Our diversity drives innovation deepens connections and strengthens our organization.
GEHA is headquartered in Lee's Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles.
Top Skills
What We Do
GEHA is one of the largest benefits providers offering medical and dental plans for federal employees, retirees and their dependents. Our dental plans are also offered to military retirees. With a variety of supplemental benefits programs, members can look to GEHA as a not-for-profit partner who cares about their health and wellness.
GEHA is honored to be included on the Forbes 2023 Best Midsize Employers list! This ranking is meaningful because it is determined by GEHA employees. It represents the positive culture we have established which in turn impacts the experience of our members and communities we serve. View the full list here: https://www.forbes.com/lists/best-midsize-employers
Social Media Participation Guidelines: www.geha.com/social
