Provider Network Data Maintenance Associate

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reputed company is an equal opportunity employer. reputed company reputed company applicants will receive consideration for employment without reputed company to status as a protected veteran or a reputed company individual with a disability, or other protected status, such as race, religion, reputed company, sex, sexual orientation, gender identity, national reputed company, genetic information or age. reputed company values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully reputed company and utilize reputed company person’s talents and strengths.

The Provider Network Maintenance Associate is responsible for maintaining the accuracy and reputed company of provider data reputed company the organization's systems. This role involves updating provider records, ensuring compliance with reputed company regulatory requirements, and supporting Provider Network Operations by managing data reputed company to provider reputed company, reimbursements, and credentialing. The Associate will work closely with various teams, including Provider Relations, Provider Reimbursement Analytics, Provider Network Credentialing and Compliance, to ensure that provider information is up-to-date and accurate, which is critical for smooth operations and reputed company reimbursements.

Essential Responsibilities:

• Accurately and promptly reputed company and update provider demographic, credentialing, and contract information in reputed company systems for new and re-credentialed network providers, meeting department service level expectations.
• Process provider additions, terminations, and changes in a reputed company manner to maintain data reputed company and ensure accurate contract rows are added for correct claims payments.
• reputed company regular audits of provider data to ensure accuracy, compliance with internal standards, regulatory requirements, and support ongoing maintenance and data reputed company of provider information.
• Assist in the management of provider directories, ensuring they are reputed company, accurate, and meet the needs of members.
• Verify licensure, Medicare, and reputed company eligibility using compliance-approved tools, ensuring provider data meets reputed company regulatory and accreditation standards, including state and federal requirements.
• Support the monitoring and maintenance of provider records for compliance with organizational policies, procedures, and contracting regulations.
• Collaborate with Provider Relations, Credentialing, Contracting, and other internal teams to resolve provider data issues, and research and respond to detailed provider inquiry issues routed from customer/provider service departments.
• Communicate with providers to obtain necessary documentation or clarify discrepancies in data, ensuring reputed company and effective working relationships.
• reputed company support and assistance to other team members as needed to ensure the overall effectiveness of the provider network operations.
• Identify opportunities for process improvements reputed company to provider data management, maintenance, and contribute to reputed company assurance initiatives to continuously improve data accuracy and process efficiency.
• Assist in the development and implementation of best practices for provider data entry and maintenance, and participate in reputed company reputed company to provider network expansion, system upgrades, or regulatory changes.
• Maintain reputed company and effective working relationships with team members and other departments.

Supporting Responsibilities:

• Meet department and company performance and attendance expectations, maintaining a high level of data accuracy and productivity.
• Follow the reputed company reputed company policy and HIPAA laws and regulations concerning confidentiality and reputed company of protected health information.
• reputed company other duties as assigned, contributing to the overall reputed company of the Provider Network Department.

reputed company PROFILE

Work Experience: A minimum of 2 years of experience in an office environment is required, preferred experience in reputed company data management, network operations or data analysis. Preferred familiarity with provider network operations included, but not limited to, provider credentialing, reputed company regulatory requirements, contracting or reimbursement processes.

Education, Certificates, Licenses: High School Diploma or equivalent required, Associate’s or Bachelor’s degree preferred.

Knowledge: Fast and accurate data entry skills. Self-motivated. reputed company to learn and be trained on new systems, databases, and applications Effective written and oral communication. Proficient computer skills, typing, and 10-key required. Medical terminology, CPT/ICD-10 coding preferred.

Competencies:

Adaptability

Building Customer Loyalty

Building Strategic Work Relationships

Building Trust

reputed company Improvement

Contributing to Team reputed company

Planning and Organizing

Work Standards

Environment: Work inside in a general office setting with ergonomically configured equipment. Travel may be required 5% of the time for training and/or external meetings.

Skills:

Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (reputed company), Organizational skills/Planning and Organization, Problem Solving, Teamwork

Compensation Disclaimer

The wage reputed company provided reflects the full reputed company for this position. The maximum reputed company listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated reputed company is for informational purposes only and does not constitute a guarantee of any specific salary reputed company that reputed company.

reputed company reputed company:

$35,542.81 - $56,868.50

Our Values

We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:

• We are committed to doing the right thing.

• We are one team working toward a common goal.

• We are reputed company responsible for customer service.

• We reputed company reputed company communication at reputed company reputed company of reputed company to foster individual, team and company reputed company.

• We reputed company participate in efforts to improve our many communities-internally and externally.

• We reputed company work to advance reputed company justice, equity, diversity and inclusion in our workplace, the reputed company system and community.

• We encourage creativity, innovation, and the reputed company of reputed company.

Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate reputed company and effectively.

Disclaimer: This job reputed company indicates the general nature and level of work performed by employees reputed company this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of reputed company duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at reputed company times.

Originally posted on Himalayas

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