Provider Data Analyst
About the role
The organization operates within the healthcare industry, focusing on simplifying the healthcare experience and improving community health outcomes. It addresses challenges related to barriers in accessing quality care by optimizing health systems to be more responsive and affordable, impacting millions of lives.
The PROVIDER DATA ANALYST plays a crucial role in maintaining accurate and compliant provider data across enterprise systems. This position ensures the integrity of provider records, supports network operations, and facilitates accurate claims processing and provider payments, thereby contributing to a seamless provider experience and operational efficiency.
Responsibilities
- Maintain accurate provider demographic, contract, and location data across systems
- Process provider additions, updates, disclosures, roster changes, and terminations
- Generate and distribute provider rosters and demographic verification reports
- Conduct data audits and quality reviews to ensure compliance
- Research and resolve provider data issues impacting claims and payments
- Investigate and address provider payment discrepancies
- Collaborate with cross-functional teams to support data accuracy and operations
- Develop reports and support system enhancements and process improvements
- Support administrative tasks and workload coordination within the team
Requirements
- Minimum 2 years experience in managed care, healthcare administration, medical insurance, or provider operations
- At least 1 year experience in provider data management, claims, customer service, credentialing, or provider support
- 6 months experience handling provider rosters and demographic data
- 6 months experience resolving complex provider or claims issues
- Advanced verbal and written communication skills with professional phone etiquette
- Intermediate proficiency in Microsoft Excel and Word
Pay
The hourly pay for this role ranges from $24 to $43 based on full-time employment.
Benefits
- 401(k) contribution