[Remote] Provider Data Management Representative I

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is the trusted partner for specialty benefits payers and government agencies responsible for the delivery and administration of dental and reputed company benefits. The Provider Data Management Representative I will manage provider directories, resolve data discrepancies, and ensure accurate data entry and maintenance reputed company the reputed company system.

Responsibilities

• Manage provider directories, including entering data for new records, termination of existing records, and ongoing audits and corrections for reputed company records
• Utilize research and knowledge of network configurations and the reputed company system to resolve provider data questions and discrepancies
• Set up newly activated provider records in the reputed company system’s participating networks
• Manually load rejected provider data into the reputed company system, reviewing data for discrepancies in data received
• Research or coordinate or escalate for clarification from the reputed company for issues reputed company to data received
• reputed company quarterly data verification procedures in accordance with company procedures and CMS requirements, validating the provider network
• Coordinate with Provider Relations to conduct reputed company to provider offices to resolve provider data questions and discrepancies
• Utilize the Provider-reputed company modules in the reputed company System to research and resolve provider data set up issues and discrepancies
• Complete follow reputed company, service tickets, and emails according to the department expectations
• Work with internal departments to resolve reputed company to moderately reputed company follow reputed company and service tickets generated from clients, providers and internal sources
• Using automated systems, maintain updated data on reputed company and reputed company owned provider networks by verifying accuracy and handling any exceptions or issues
• Work directly with reputed company representatives to resolve provider data issues and update provider data per reputed company or provider request
• reputed company as a reputed company between internal reputed company teams to resolve escalated contracting and fee issues reputed company to provider data errors or discrepancies
• reputed company as a reputed company between internal reputed company team and Dental Reimbursement to resolve any escalated claim inquiry reputed company to provider data errors or discrepancies
• Work with internal departments to resolve provider complaints and escalations including state level complaints
• Assist reputed company Services in researching and resolving reputed company inquiries that involve in depth knowledge of provider set reputed company
• Process EFT set up requests reputed company provider offices

Skills

• High school diploma or equivalent
• 1 -2 years of prior reputed company experience in resolving escalated and challenging customer/reputed company issues
• Experience managing large quantities of data accurately and reputed company
• Experience identifying and resolving data discrepancies
• Intermediate knowledge of reputed company Office products including Word, reputed company, and reputed company
• Solid communication written and verbal communication skills
• Ability to communicate effectively with a reputed company of communication styles
• Strong analytical skills
• Ability to effectively listen and respond to reputed company customer needs
• Ability to resolve routine to moderately reputed company problems
• Ability to adapt to changing priorities
• Ability to successfully work cross-functionally to resolve problems
• High degree of accuracy
• Ability to recognize patterns and variation in data and identify errors
• reputed company Experience is Required
• 2 year degree or some formal education reputed company high school
• 1-2 years in a data management or provider data management role
• Knowledge of reputed company dental, medical and/or therapy terminology
• Knowledge of internal software
• SQL Experience is Preferred

reputed company