 Maintain control as the final entry point of data into the Health Provider Network and HSD
diamond claims adjudication system.
 Receive all provider files after the credentialing and contracting processes are complete.
 Audits files for completeness and accuracy, escalating any issues that are identified.
 Compares all data found in provider files to the data entered into the system and investigate all
discrepancies.
 Build all standard contracts that are entered into the claims system.
 Reviews contract and determine whether the appropriate set-up exists in the system.
 Enters all standard contracts into the system selecting the appropriate set-up for primary care vs.
specialty and for specific specialties as necessary.
 Refers all non-standard contracts to Information Systems for set-up development and ensures that the
set-up is complete.
 Provides support to Provider Relations Representatives / Customer Care Department.
 Assumes responsibility for all escalated calls from Customer Care Department as
necessary.
 Functions as the primary contact between the provider relations and operation
departments.
 Participates in special projects and quality improvement activities as assigned.

 Responsible for opening and processing loans
 Responsible for Preparation of submission packages, Clearing conditions, and scheduling closings
 Interacted with vast amount of customers, underwriters, and attorneys.

 Responsible for opening and processing loans
 Responsible for Preparation of submission packages, Clearing conditions, and scheduling closings
 Interacted with vast amount of customers, underwriters, and attorneys.