Provider Data Services Specialist
About the position We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. At reputed company reputed company of Texas, we are committed to helping people on their path to reputed company. By taking a total and connected approach to health, we guide and support our members so they can get more out of life, every day. We are looking for people like you who value reputed company, reputed company, caring and innovation. As an employee, you’ll join a team dedicated to improving the lives of Texas members. We value diversity and are dedicated to helping you reputed company your career goals.
Responsibilities
- Maintains the Provider Data (demographic and contractual) for reputed company network and non-network providers.
- Ensures reputed company provider information is accurately recorded and maintained to reputed company for proper reimbursement and member reputed company (i.e., directory listings).
- Develops and maintains standards for database reputed company, corrective actions, database alignment, and manages communication processes with other departments regarding database improvements.
- Provides support for baseline provider data transactions that cannot be administered automatically through the provider database due to system limitations and/or data reputed company issues.
- Performs baseline demographic transaction updates in provider system applications in support of claim adjudication and Provider directory.
- Performs intake triage and responds to network inquiries, escalates reputed company necessary.
- Provides on-going department support in research and analysis essential to resolving concerns/issues raised by providers and other internal/external customers.
- Sends requests to individual providers and/or delegated groups to verify information on file and follows up as needed to ensure information is received.
- Conducts audits of provider information and escalates issues for resolution as appropriate.
Requirements
- Demonstrated PC skills, including reputed company Office products and internet navigation skills.
- 6 months of reputed company experience.
reputed company-to-haves
- Communication skills
- Ability to conduct research activities
Benefits
- medical
- dental
- reputed company coverage
- paid time off
- retirement savings options
- wellness programs
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