Data Integrity Specialist

AllCare Management Services•Grants Pass, OR

1d•$24 - $27•Hybrid

About The Position

This position is responsible for validating provider data reflected in the provider portal, directory, DSN, network adequacy, VBP and other reporting. Assists in quality checks and reconciliation of the data across systems to ensure accuracy of reporting across the organization. Ensures the efficient and timely completion of front-end provider data intake and validation for all health care providers and facilities.

Requirements

Ability to perform essential job duties with or without reasonable accommodation and without posing a direct threat to safety or health of employee or others.
High school diploma or general education degree (GED).
One to two years related experience and/or training in Healthcare or Insurance industries
Certification from NAMSS in CPCS and CPMSM or actively pursuing the certification.
Familiarity with the Healthcare industry.
Excellent organization and time-management skills.
Excellent computer skills, including the Microsoft Office Suite (Outlook, Word, PowerPoint, and Excel).
Knowledge of and compliance with HIPAA regulations.
Knowledge of operating systems, programming languages, software programs, networks and other technologies.
Excellent at identifying and implementing improvement activities and ensuring excellence.
Excellent at interpreting data and using it to solve problems and gain new insights.
Excellent at locating information and synthesizing information from various sources.
Demonstrate accountability, inspiring trust and confidence from others.
Self-resolve most conflicts or misunderstandings with minimal need for direct supervision.
Work with high initiative, energy and effectiveness in a fast-past environment.
Effectively and professionally communicate with team members and customers.
Collaborate within a multidisciplinary, diverse team to provide professional service.
Prioritize and organize work according to competing timelines.
Allocate your time so that you can complete tasks within established deadlines.
Adapt to change, learn quickly, and work with ambiguity.
Use creativity and resourcefulness to solve new problems.
Cope and self-manage during stressful situations.
Meet timelines for goals with high level of quality.
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
Ability to write reports, business correspondence, and procedure manuals.
Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Job requires specialized computer skills. Must be adept at using various applications including database, spreadsheet, report writing, project management, graphics, word processing, presentation creation/editing, communicate by e-mail and use scheduling software.
Ability to solve practical problems and work with a variety of concrete variables in situations where only limited standardization exists.
Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Nice To Haves

Being bilingual in another language, including American Sign Language (ASL), is an invaluable skill that enhances our ability to deliver culturally responsive care.

Responsibilities

Validates required elements for portal, directory, credentialing and EzCap configuration
Supports DSN, VBP, and network adequacy input and reporting
Maintains a high quality, timely and accurate credentialing in-take process for medical healthcare providers
Owns initial intake (applications, rosters, forms, demographic changes, network adequacy)
Maintains up-to-date knowledge of NCQA, URAC, and JACHO credentialing standards.
Works collaboratively and coordinates with Provider Engagement, Provider Setup, Credentialing, Contracting and other departments
Ensures complete and accurate documentation before data moves to setup
Maintains punctual, regular and predictable attendance.
Meets all required training including those listed in Relias Learning Module System (LMS).
Performs other duties as assigned