Data Specialist Provider Relations

Job Overview

Job Description

Data Specialist Provider Relations needs 4+ years’ experience
Data Specialist Provider Relations requires:
Associate or Bachelors Degree
• Customer service and/or data analysis experience
SQL, R, Excel, experience with complex data cleansing, integration and reconciliation, experience with process automation
• Experience within health care industry
• Problem solving skills/decision making abilities
Understands the credentialing process and provider impacts of the credentialing process.
• 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

Data Specialist Provider Relations duties:
• 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.
• Assists management with database/data integrity issue research and recommends resolutions. Identifies trends related to data structure/set up 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 set up.