Provider Data Management Analyst I
Core
Manage provider enrollment and data updates to ensure claims and directory accuracy within a provider data management system.
Role type
Provider Data Management Analyst
Builds
Accurate provider directories and claims data for managed care/insurance operations
Domain
Healthcare operations / Insurance
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Data entry, Data analysis, Provider enrollment management, Claims processing knowledge, Provider relations, System research, Quality checks, Excel proficiency
Preferred skills
Healthcare operations experience, Credentialing experience, Managed care environment experience
Responsibilities
Enroll providers and practitioners into the provider data management system, Update provider and practitioners with claims payment and directory information, Research, review, and make updates within the provider data management system per provider requests, Perform quality service checks on systemic data, inclusive of claims processing and provider directory information, Perform research and resolve problems as necessary
