Network Data Specialist

Job Posting End Date: August 31

About the role

The Network Data Specialist (NDS) is responsible for researching and resolving provider data issues across claims processing and record management systems. The role requires judgment to evaluate incomplete or conflicting information, reconcile discrepancies, determine root cause, assess downstream business and regulatory impact, and decide when issues can be resolved within scope versus through cross-functional collaboration or escalation. This work directly supports claims accuracy, provider directories, network reporting, compliance, privacy, and data-driven business decision-making.

Responsibilities

• Research and diagnose provider data issues by evaluating and reconciling information across multiple systems and sources.
• Determine root cause of data discrepancies and assess downstream impacts to claims adjudication, reporting accuracy, provider directories, privacy incident occurrence, and regulatory compliance.
• Apply sound judgment to evaluate incomplete or conflicting information and determine the appropriate resolution approach, including whether issues can be resolved within scope, require cross-functional collaboration, or warrant escalation.
• Perform provider, location, and payee data updates in accordance with established standards and configuration guidelines when corrective action is within scope.
• Support accurate and timely resolution of issues affecting claims processing, provider records, and payment accuracy.
• Provide cross-functional partners (e.g., claims or network teams) with clear research findings, impact assessments, and recommended actions to support issue resolution.
• Document research, decisions, actions taken, and outcomes with clarity to support auditability, consistent handling, and data integrity.
• Ensure all work meets established quality, compliance, and documentation standards.
• Identify recurring data issues, root causes, and provide recommendations to improve data standards, workflows, and operational reliability.
• Manage and prioritize work received through multiple intake channels (e.g., system queues, shared inboxes, and structured workflows) based on urgency, business impact, and turnaround expectations.

Requirements

• Bachelor’s degree preferred, or equivalent combination of education and experience
• 2+ years of experience in a data-centered, technical, analytical, or metrics-based operations role preferred
• Demonstrated ability to research issues, evaluate incomplete or conflicting information, determine root cause, and recommend or implement appropriate solutions using sound judgment
• Demonstrated ability to assess downstream impacts and communicate findings, risks, and recommended actions clearly
• Strong working knowledge of provider data, claims processing, and downstream data dependencies across reporting, compliance, and operational processes
• Proficiency in Microsoft Excel and the ability to utilize systems, tools, and available resources to investigate and validate information
• Strong written and verbal communication skills
• Ability to work effectively with cross-functional teams to support issue resolution and data accuracy
• Strong critical-thinking, analytical, and problem-solving skills
• High attention to detail and commitment to data accuracy and integrity
• Ability to manage competing priorities in a dynamic, deadline-driven environment

Benefits

• Competitive benefits package including:
  • Health, Vision, Dental
  • Short & Long-Term Disability
  • Generous PTO (including paid time to volunteer!)
  • Up to 9.5% 401(k) employer contribution
  • Mental health support
  • Career advancement opportunities
  • Student loan repayment options
  • Tuition reimbursement
  • Flexible work environments
• Performance Based Incentive Plans
• Award-winning culture with inclusion and diversity as a priority

All benefits listed above are subject to the terms of their individual Plans.

Pay

The base salary range for this position is $36,000.00 - $62,400.00. Actual pay will be based on skill, geographical location, and experience.

About the company

Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland, and the UK, Unum also has significant operations in Portland, ME, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide.