Provider Data Specialist in Chandler, Arizona

LHH

Chandler, Arizona

Contract/Temp to Hire

$22.00 - $24.00Hour

A well-established healthcare organization in Chandler is seeking a Provider Data Specialist to join their team! This is a long term, full time opportunity. Training will be in office with the ability to work remote once training is complete. Must reside in Arizona due to the job requirements. Experience in credentialing, contracting or claims is a HUGE plus!

Job Duties:

  • Ensure the provider record contains all relevant information regarding certifications, accreditations, and licensing.
  • Enter provider data according to the format specifications
  • Conduct reports identifying records from providers and vendors that do not meet the requirements.
  • Identify claims that require provider or vendor additions by running SQL queries
  • Update the provider's contract status information when a contract's effective date or termination date is notified,
  • Identify provider health plan panels and contracts that are not in effect on the date of service using reports to determine claim errors that require provider data updates.
  • Develop a thorough understanding of contracts, the Division of Financial Responsibility (DOFR), network areas, and coverage areas.
  • Timely completion of reports and addition/editing of data
  • Additional duties as assigned by your manager

Requirements

  • HS Diploma or equivalent
  • Minimum of one year experience using EzCap, ExCel and Crystal Reports.
  • Minimum of one year experience processing claims/contracting or credentialing
  • Minimum of one year experience in the medical or health related field.
  • Knowledge of Medicare rules, medical terminology, and managed care health plan rules and regulations, contracts, DOFR’s, ICD-9, CPT and RVS codes.

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records

RefUS_EN_27_842405_2936299

Provider Data Specialist

LHH

17 days ago

$22.00 - $24.00Hour

Contract/Temp to Hire

Chandler, Arizona

A well-established healthcare organization in Chandler is seeking a Provider Data Specialist to join their team! This is a long term, full time opportunity. Training will be in office with the ability to work remote once training is complete. Must reside in Arizona due to the job requirements. Experience in credentialing, contracting or claims is a HUGE plus!

Job Duties:

  • Ensure the provider record contains all relevant information regarding certifications, accreditations, and licensing.
  • Enter provider data according to the format specifications
  • Conduct reports identifying records from providers and vendors that do not meet the requirements.
  • Identify claims that require provider or vendor additions by running SQL queries
  • Update the provider's contract status information when a contract's effective date or termination date is notified,
  • Identify provider health plan panels and contracts that are not in effect on the date of service using reports to determine claim errors that require provider data updates.
  • Develop a thorough understanding of contracts, the Division of Financial Responsibility (DOFR), network areas, and coverage areas.
  • Timely completion of reports and addition/editing of data
  • Additional duties as assigned by your manager

Requirements

  • HS Diploma or equivalent
  • Minimum of one year experience using EzCap, ExCel and Crystal Reports.
  • Minimum of one year experience processing claims/contracting or credentialing
  • Minimum of one year experience in the medical or health related field.
  • Knowledge of Medicare rules, medical terminology, and managed care health plan rules and regulations, contracts, DOFR’s, ICD-9, CPT and RVS codes.

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records

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