Provider Data Analyst

CommonSpirit Health • Bakersfield, CA

1d • Remote

About The Position

The Provider Data Analyst maintains DHMSO’s provider data network in QNXT. The role creates and updates provider records, coordinates with Contracting and Credentialing to resolve questions, and partners with Configuration, Claims, and Enrollment to help ensure claims are paid accurately and on time. The position maintains demographic and contractual data for network and non-network providers and ensures information is accurate to support proper reimbursement and member access, including directory listings. This remote role may be based anywhere in the United States, with work during Pacific Time business hours. The employer provides equipment for working from home, including a laptop, docking station, dual monitors, and accessories.

Requirements

• Bachelor’s degree or equivalent experience.
• At least 3 years of experience managing provider data and working in QNXT.
• Proven ability to work with other business functions.
• Working knowledge of DHPR and CMS rules for claim submission, claim payment, and eligibility appeals for Commercial, Medicare, and Medi-Cal lines of business.

Responsibilities

• Complete provider load templates, understand required data elements, and resolve records that produce errors.
• Maintain and update monthly rosters for multiple participating groups.
• Troubleshoot provider-load configuration issues based on testing results.
• Maintain demographic and contractual data for network and non-network providers.
• Ensure provider information is accurately recorded and maintained to support proper reimbursement and member access, including directory listings.
• Develop and maintain standards for database integrity and database alignment.
• Manage communication processes with other departments regarding database improvements.
• Work with Contracting and Credentialing on provider-data questions.
• Partner with Configuration, Claims, and Enrollment to help ensure accurate and timely claim payment.

What This Job Offers

• Job Type: Full-time