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Provider Data Maintenance Specialist
CareAllies. Analyze, research, and apply business rules to requests from providers regarding additions, deletions, and changes to provider information .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in provider data management, including contracting and credentialing processes, while ensuring data accuracy and compliance. Strong analytical skills and effective communication abilities facilitate collaboration with various stakeholders.
Highest-signal resume keywords
Provider Data ManagementProfessional Provider Credentialing ProcessAnalytical SkillsMicrosoft Office ApplicationsBilingual Spanish
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Provider CredentialingData AnalysisContract AdministrationClaims ProcessingData Accuracy
Soft Skills
Written CommunicationVerbal CommunicationInitiativeIndependence
Tools & Technologies
Microsoft ExcelMicrosoft AccessMicrosoft PowerPointSalesforce
Industry Keywords
Provider InformationNetwork ContractingQuality InitiativesMembership AssignmentInternal Provider Meetings
About the role
Key responsibilities & impact- Analyze, research, and apply business rules to requests from providers regarding additions, deletions, and changes to provider information
- Review contracting, credentialing, and maintenance of provider data
- Support claims payment, marketing, membership, and network contracting across all lines of business
- Administer provider contracts, rosters, and requests accurately and timely
- Support quality initiatives to ensure data accuracy
- Participate in internal provider meetings and work groups
- Research problems related to provider credentialing, data, and network participation
- Liaise between Network Contracting, Enterprise Credentialing, Product Development, Special Investigations, Legal, Marketing, Full Service Units, ITG, Government Programs, and other business partners
- Maintain provider data used for claims processing, membership assignment, and directory purposes
Requirements
What you’ll need- 2 years of college and/or 2 years of relevant experience
- Written and verbal communication skills to interact with internal and external customers
- Analytical and quantitative skills
- Ability to take initiative and work independently
- Must live in or near El Paso, Texas
- Must reside within a reasonable commute distance to the El Paso, Texas local office
- Working knowledge of Professional Provider Credentialing Process (preferred)
- 1 year of experience on the Provider Data (preferred)
- Experience with Microsoft Office applications including Excel, Access, and PowerPoint (preferred)
- Bilingual Spanish highly preferred, but not required
- Experience using Salesforce a plus
Benefits
Comp & perks- Curated development plans that foster growth and promote rewarding, fulfilling careers
- Health and wellness benefits
- 401(k) savings plan
- Pension plan
- Minimum of 15 days of paid time off
- Paid parental leave
- Disability insurance
- Supplemental life insurance
- Employee assistance program
- Paid holidays
- Tuition reimbursement
- Other incentives
- Annual incentive bonus plan subject to the terms and conditions of the plan