Senior Provider Data Maintenance Specialist

Senior Provider Data Maintenance Specialist

  Not Disclosed

  Albuquerque, NM

  24.0 Months

  Not Disclosed

  Not Disclosed

  Healthcare

Job Description

Sr Prov Data Maintenance Specialist

This position is responsible for the analyzing, researching, and applying business rules to complete requests received from providers regarding adds/deletes/changes to their information used for claims processing, membership assignment, and directory purposes. This position is responsible for contracting, credentialing and maintaining Facility / Professional provider data to support marketing, network contracting across all lines of business. This role involves supporting the implementation of special projects, assisting with tracking of various phases of a project and managing workflow. This position includes assisting management in familiarizing and training team members with the various business rules in network contracting and credentialing across all lines of business. In addition is responsible for identifying gaps in processes and suggesting process improvement strategies.

Required Job Qualifications:

Bachelor degree plus 1 year of experience with Provider Network contracting and credentialing systems OR 5 years of experience in the Health Care industry.
Written and verbal communication skills including interpersonal skills. Skills to develop training materials and act as an advisor to staff
Experience and proficiency inn Microsoft Office software products including analytical tools. Experience developing reports.

Preferred Job Qualifications:

Subject Matter Expert for the Professional Provider Credentialing Process
2 years of experience with current government sponsored health insurance networks
Knowledge of health care delivery systems, claim costing analytics, and provider network adequacy analytics

Note :

Onsite
Contract to Hire
VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.