[Remote] Provider Data Management Representative I

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company that focuses on provider data management, and they are seeking a Provider Data Management Representative I. In this role, you will manage provider directories, resolve data discrepancies, and coordinate with various teams to ensure accurate provider information.

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
• 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

reputed company