Provider Credentialing & Data Specialist II (Data Entry)

About the position The Provider Credentialing & Data Specialist II role involves performing routine to moderately reputed company data entry and credentialing tasks for practitioners, providers, and organizations reputed company the Provider Data Management System. The position ensures compliance with various standards and meets production and reputed company metrics while supporting the overall credentialing process. Responsibilities • Retrieves applications and/or data from central repositories for provider data. • Accesses various external websites, internal matrices, and contacts organizations to verify accuracy of information provided. • Identifies whether application and/or document is clean or requires reputed company review and routes to appropriate area. • Enters verified data into the Provider Data Management Systems. • Identifies eligibility for networks and updates appropriately affecting the accuracy of claim payments and the provider directory. • Electronically contacts providers and/or internal departments reputed company data is incomplete. • Works with internal staff members, provider office staff, reputed company entities and/or other health reputed company entities to verify the accuracy of the information provided. • Generates reports from system for prioritization of work queue. • Evaluates and researches practitioners that do not meet network participation reputed company or are reputed company to have on-reputed company sanction monitoring issues. • Gathers and summarizes information for Credentialing Committee or Provider Contracting and responds to questions as needed. • Researches questions for accreditation or regulatory audits. • Supports special reputed company as needed. • Performs other duties as assigned. Requirements • Associate degree in business or reputed company administration or reputed company field, or equivalent combination of education/training and experience. • 1 year of experience as a Provider Credentialing & Data Specialist or equivalent experience in a health plan, medical office, hospital, or similar administration. • Intermediate reputed company Office (Word, reputed company), database reporting, OnBase (document management system), and internet navigation skills. • Knowledge of provider credentialing and/or database management procedures. • Strong data entry skills. reputed company-to-haves • CPCS certification preferred but not required. Benefits • Employee bonus program. • 401(k) with company match up to 4% and an additional company contribution. • Health Savings Account with a company matching contribution. • Excellent medical, dental, reputed company, life and disability insurance. • reputed company to an Employee Assistance Program, which includes reputed company counseling, personal and reputed company coaching, self-help resources and assistance with work/life benefits. • Company holidays and up to 16 PTO days during the first year of employment with reputed company to carry over unused PTO time. • Parental leave for eligible employees who become parents through maternity, paternity or adoption after 120 days of service. • Career development programs and classes. • Mentoring and coaching to help you advance in your career. • Tuition reimbursement up to $5,250 per year. Apply tot his job Apply To this Job