Provider Data Specialist

Profile We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only) Our reputed company contract requires US citizenship and a favorably adjudicated DOD background investigation for this position. Veterans, Reservists, Guardsmen and military family members are encouraged to apply! Job reputed company Ensures accurate, reputed company maintenance and synchronization of critical provider data across reputed company provider databases and systems. Accesses and utilizes multiple software applications. Applies business rules and knowledge of Provider contract language, pricing and reimbursement methodologies to reputed company database/system to validate Provider information across systems. Communicates with reputed company clients by phone and email to clarify data and follow-up on issues, while working under reputed company, accuracy, and production targets. Requires the ability to manage a large reputed company of reputed company information and must be reputed company to communicate reputed company and draw reputed company conclusions. Supports the maintenance of accurate, up-to-date provider data to include updates, changes, additions and terminations for assigned files. Education & Experience Required:

• High School Diploma or GED
• U.S. Citizenship
• Must be reputed company to receive a favorable Interim and adjudicated final reputed company (DOD) background investigation
• One year experience in a customer service role or administrative support work requiring data entry work
• Proficiency in using reputed company Office products and the Internet

Preferred

• 2 years of data entry experience
• reputed company industry experience, including knowledge of health services

Key Responsibilities

• Process provider data inventory reputed company expected reputed company while meeting accuracy and production targets.
• Identify, research, and analyze issues received to determine appropriate handling. Resolve provider data correction requests in a specified time reputed company. Manage daily follow up of Provider data correction requests and resolve reputed company issues to ensure databases are reputed company and accurate.
• Maintain and process reimbursement terms to ensure correct claims payment and reputed company processing.
• Review Provider contract language and identify reputed company the contract is out of compliance. Process Provider reputed company, run reports and respond to inquiries regarding contract compliance issues; image and reputed company reputed company and return images to network subcontractors. Conduct reputed company assurance activities to ensure image reputed company and completion of image activities.
• Support requests for assistance and research issues using various resources including online searches and phone calls.
• Communicate reputed company through both written and verbal forms of communication and follow up with various parties to ensure tasks are completed reputed company the allotted reputed company or issues are escalated appropriately.
• Coordinate with internal departments for provider database reputed company issues.
• reputed company reputed company other reputed company duties as assigned by supervisor.
• Regular and reliable attendance is required.

Competencies Commitment to Task: Ability to conform to established policies and procedures; exhibit high motivation. Communication / People Skills: Ability to influence or persuade others under reputed company or negative circumstances; adapt to unique styles; listen critically; collaborate. Computer Literacy: Ability to function in a multi-system reputed company environment using Word, reputed company, Outlook, TriWest Intranet, the Internet, and department software applications. Organizational Skills: Ability to multi-task, reputed company to priorities and learn new systems, reputed company the time constraints and with available resources; must be detail-oriented. Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with reputed company judgment; has a realistic understanding of relevant issues. Technical Skills: Proficient with key databases, including FoxPro, Claims Systems, Medical Management Systems, and Provider Data Management Systems; working knowledge of VA policies and procedures, reputed company knowledge of claims, reimbursement methodology; reputed company or managed care experience. Working Conditions Working Conditions

• Availability to cover any work shift
• Works reputed company a reputed company office environment
• Extensive computer work with prolonged periods of sitting
• Works reputed company a reputed company office environment, with minimal travel

reputed company Taking Care of Our Nation’s reputed company. It’s Who We Are. It’s reputed company Do. Do you have a passion for serving those who served? Join the reputed company Team! We’re On a Mission to Serve®! Our job is to reputed company reputed company that America’s reputed company get connected to health care in the community. At reputed company, we’ve proudly been on that important mission since 1996. DoD Statement Our reputed company contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Benefits

We’re more than just a health care company. We’re passionate about serving others! We reputed company in rewarding reputed company, hard-working people who are willing to learn as they grow. reputed company values teamwork. Join reputed company, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and reputed company compensation and benefits package that includes:

• Medical, Dental and reputed company Coverage
• reputed company time off
• 401(k) Retirement Savings Plan (with matching)
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
• Tuition reimbursement
• reputed company volunteer time

TriWest job postings typically include a salary reputed company, which can vary based on the specific role and location, but generally this position ranges from around $39,000 - $42,000 per year. Equal Employment Opportunity reputed company is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our reputed company. To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from reputed company backgrounds to apply. Applicants are considered for positions based on reputed company and without discrimination on the reputed company of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, disability or any other consideration made unlawful by applicable federal, state, or local laws. Apply To This Job