Provider Data Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Maintain and refresh provider information within Provider Data Management systems.

• Confirm provider data from external sources, including provider applications and credentialing teams, and update systems as necessary.

• Collaborate with both internal and external partners to gather missing or incomplete data and ensure adherence to regulatory standards.

• Oversee data quality and precision, identifying and rectifying discrepancies.

• Address inquiries from internal and external stakeholders concerning provider data.

• Create reports to monitor data accuracy, completeness, and timeliness.

• Work alongside claims, customer service, and network management teams to address provider-related issues.

• Support audits and data verification efforts to ensure compliance with industry standards.

• Offer training and assistance to internal teams regarding provider data management systems and procedures.

• Keep abreast of industry standards, regulatory requirements, and best practices in provider data management.

⛳️ Requirements

• High school diploma or equivalent is required.

• A minimum of 3 years in provider data management, healthcare administration, or a related field.

• Familiarity with healthcare provider directories, claims processing, and credentialing is advantageous.

• Proficient in data management software, Microsoft Excel, and Microsoft Office.

• Experience with NPPES and similar tools is preferred.

• Knowledge of NCQA or CMS regulations is an asset.

• Strong attention to detail and analytical skills are essential.

• Excellent written and verbal communication skills.

• Ability to work both independently and as part of a team.

• Strong organizational and time management abilities.

• Proficient in problem-solving and critical thinking.

• The company is currently unable to offer visa sponsorship (H1B or otherwise).

🏝️ Benefits

• Comprehensive health, dental, and vision insurance.

• Retirement savings plan with company match.

• Generous paid time off and holiday schedule.

• Opportunities for professional development and advancement.

• Flexible work arrangements available.