Company Description
We are seeking a
Provider Data Management (PDM) Specialist
to oversee and maintain accurate provider records within our health plan systems. This role involves entering and updating provider data and demographic information in internal systems, while ensuring accuracy and compliance with policies and regulations. The ideal candidate should possess strong attention to detail, analytical skills, and experience working with provider networks and healthcare databases.
Accurately enter, update, and maintain provider information in internal systems
Validate provider credentialing data, contracts, and demographic data to ensure accuracy
Ensure provider records are in compliance with CMS, HIPAA, and state/federal regulations
Conduct routine audits and reconciliations to maintain data integrity.
Review and load the required data into the health plan system as the process guidelines require
Manage and monitor daily activities and meet the set targets
Work independently and complete the tasks in established timeframe with minimal supervision
Excellent written communication skills in English with strong clarity and accuracy
Strong reading and listening comprehension skills in English to effectively process the requests
Strong customer focus, with a passion for delivering exceptional service and support
Proficiency in Microsoft Office Suite and experience navigating web-based applications
Typing speed of at least 40 words per minute, with accuracy and efficiency
All your information will be kept confidential according to EEO guidelines.
EEOC and Veteran Documentation
During employment, employees are treated without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status.
At times, government agencies require periodic reports from employers on the sex, ethnicity, handicap, veteran and other protected status of employees. The purpose of this Administrative EEO Record is for statistical analysis only and is used to comply with government record keeping, reporting, and other legal requirements. The completion of the Administrative EEO record is optional. Administrative EEO Records are kept in a Confidential File and are not part of your Application for Employment or Personnel file.
INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.
Provider Data Management Specialist in remote at Unknown Company
This position is listed as contract and onsite.