Provider/Relations Data Specialist – Remote / Telecommute

Job Summary

Talentify.io, is currently hiring on a vacant job post of Provider/Relations Data Specialist – Remote / Telecommute based in United States. Please read the job detail carefully before applying.

Job Title: Provider/Relations Data Specialist – Remote / Telecommute
Company Name: Talentify.io
Job Type: Full Time
Job Location: United States
Salary:
Job Link Expiry: 2022-09-02
Posted on: jobsintelecom.net

Job Detail

Talentify helps candidates around the world to discover and stay focused on the jobs they want until they can complete a full application in the hiring company career page/ATS.

Responsibilities

Receives, researches, and processes provider/location requests related to additions, changes, and terminations and ensures all requests are logged in the appropriate database for performance measurement.

Evaluates, researches and resolves complex provider data maintenance requests and issues.

Understands the systems, business process, and provider impact of alternative set-ups.

Evaluates, researches and resolves credentialing requests and issues. Understands the credentialing process and provider impacts of the credentialing process.

Assists management with database/data integrity issue research and recommends resolutions.

Identifies trends related to data structure/setup and reports trends with proposed solutions to management.

Identifies opportunities to improve processes to ensure efficient turnaround of issues and meets and exceeds established deadlines and performance standards.

Develops and maintains departmental policies and procedures documentation related to provider data setup.

Responds to telephone calls, emails, and written requests from providers/locations as well as internal client departments related to provider/location set up in the system.

Ensures efficient, accurate, and timely responses to provider requests related to participation in the client panel.

Educates providers on plan participation, eligibility and authorization processes through the use of the Web or IVR.

Educates providers regarding contractual obligations.

Identifies training opportunities for client Customer Care Center to ensure more accurate responses to provider questions.

Distributes provider/location contracts and follows up to ensure all appropriate contracts are executed before provider/location participation on a panel.

Develops and maintains direct relationships with the claims department to coordinate return checks and ensure providers/location payment information is maintained to ensure efficient payments to providers.

Assists in ensuring all appropriate documentation is maintained in the document management applications.

Meets performance and quality metrics.

Implements/participates in other provider relations team projects as requested.

Basic Qualifications

High school diploma.

1-year Experience Required.

Proficient with Microsoft Office (Word and Excel).

Ability to manage time and multiple tasks effectively.

High level of accuracy and attention to detail.

Associate or Bachelor’s Degree.

Customer service and/or data analysis experience.

Experience within the healthcare industry.

Problem-solving Skills/decision-making Abilities.

Analytical ability in understanding business processes/impact of decisions.

Strong critical thinking skills.

Developed oral/written communication skills.

Ability to handle escalated provider issues, including direct provider calls.

Brief Description of Work to be Performed: Support new provider data set up in legacy system while RTB team moves to new Facets platform.

Credentialing/Assignment will need to be dual maintenance until we move those functions to a new platform.

These temps will augment the team to support the need for dual entry across multiple systems.

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