Provider Data Coordinator II

Provider Data Coordinator II

Requirements

• High school diploma or equivalent
• 3+ years of provider data or network administration experience, preferably in managed care
• Proficient in Microsoft Access and Excel applications
• Experience with data management in large databases, reporting, and analysis preferred

Responsibilities

• Analyze inbound request to determine accuracy and route request to provider changes or other cross functional teams
• Maintain provider data management systems for accuracy
• Handle and resolve provider data issues, such as mass change updates, limited reconciliations and direct submissions of urgent requests
• Coordinate provider data between the health plan database and various internal databases
• Participate in reconciliation and provider data projects
• Review, investigate and resolve inquiries regarding loaded providers that may have issues reported from internal and external customers
• Submit daily and weekly internal and external status reports
• Initiate and process provider add, change and termination forms
• Track, update and audit provider information in database
• Assist in Corporate audit activities or requests for claims provider set up

Preferred Qualifications

• Associate’s degree in related field preferred
• Experience with data management in large databases, reporting, and analysis preferred