Provider Data Management Specialist
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Job Description
• 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
• Must be able to prioritize and complete all job duty requirements
• Must be able to adhere to changes based on department and/or business
Requirements
Function: Health Care Provider
Experience Level: Associate