Provider Data Analyst

Dignity Health Management Services•Bakersfield, CA

2d•$32 - $48•Remote

About The Position

The Provider Data Analyst maintains Dignity Health Management Services Organization's provider data network in QNXT. The role creates and updates provider records and collaborates with Contracting, Credentialing, Configuration, Claims, and Enrollment to support accurate, timely claim payments. The analyst works with provider load templates, ensures required data elements are completed, and resolves records that encounter errors. Responsibilities also include maintaining monthly rosters for multiple participating groups, troubleshooting provider-load configuration issues based on testing results, and maintaining demographic and contractual data for network and non-network providers. Accurate provider information supports proper reimbursement and member access, including directory listings. The analyst develops and maintains database integrity and alignment standards and communication processes for database improvements. This is a remote position that may be based anywhere in the United States. The employer provides work-from-home equipment, including a laptop, docking station, dual monitors, and accessories. The employee is expected to work Pacific Time business hours.

Requirements

Bachelor's degree or equivalent experience.
Minimum of three 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

Work on provider load templates, understand the required data elements, and resolve provider records that error out during loading.
Maintain and update monthly rosters for multiple participating groups.
Troubleshoot provider-load configuration issues based on testing results.
Maintain demographic and contractual provider 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 alignment.
Manage communication processes with other departments regarding database improvements.
Create and update provider records in QNXT.
Work with Contracting and Credentialing on questions and partner with Configuration, Claims, and Enrollment to support accurate and timely claim payments.