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Provider Data Specialist

Company: CareNational
Location: Chesapeake
Posted on: May 3, 2021

Job Description:

Healthcare Data Support Specialist - Managed Care Chesapeake, VA ** This is a Full Time, Benefits Available, CONTRACT opportunity, expected to last around 1-2 months! ** Data Specialist Job Summary: The Healthcare Data Specialist plays an integral part in the maintenance of accurate databases and reports in order to monitor network compliance with federal and state requirements. Responsible for providing data entry and data management support within the health plan, as it relates to the contracted provider network and federal and state requirements. Create and maintain multiple databases, including: contracted provider network prior authorization third party liability provider set ups and related corrections Oversee the provider termination process including adding and changing new or existing provider records in the medical information system Schedule monthly provider verifications regarding provider enrollment specifications and demographic changes Update delegated provider Medicare and Medicaid documents on a monthly and ad hoc basis and ensure state compliance Provide appropriate reports and statistical data to other department designees for review, follow-up and resolution Data Specialist Background: Requires an education level of at least a high school diploma or GED; Associate's degree is a plus. Strong data entry skills required. At least 1 year experience in a medical office, hospital or health plan call center, or other healthcare support role with heavy computer & database use. 1-3 years experience in claims processing, provider, or credentialing preferred. Strongly prefer 1 or more years at a Managed Care Organization (Health Plan, IPA/Medical Group, HMO, TPA/MSO, etc). Requires basic to intermediary familiarity with Medical terminology (1-3 years direct experience). Basic knowledge of health care delivery systems, Managed Care Organizations as well as Medicaid/Medicare and related state programs is needed. Proficient in Microsoft Office applications, with demonstrable skills in Access and Excel, and the ability to learn new and complex computer system applications. Previous experience with database management, data reporting, and data analysis preferred. Must have a minimum of 30 wpm typing with a high level of accuracy. Gisselle Dela Pea Search Consultant CareNational gisselle@carenational.com 410.983.9864 (CALL - TEXT - FAX) See the latest @ CareNational Media !

Keywords: CareNational, Chesapeake , Provider Data Specialist, Other , Chesapeake, Virginia

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