Provider Data Coordinator II

Centene Corporation

1d • $23 - $40 • Remote

About The Position

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform day to day functions to inbound requests and maintain provider database. Audit analyses on completed requests and monitor compliance status of submitted requests. Analyze inbound request to determine accuracy and route request to provider changes or other cross functional teams Maintain provider data management systems for accuracy Handle and resolve provider data issues, such as mass change updates, limited reconciliations and direct submissions of urgent requests Coordinate provider data between the health plan database and various internal databases Participate in reconciliation and provider data projects Review, investigate and resolve inquiries regarding loaded providers that may have issues reported from internal and external customers Submit daily and weekly internal and external status reports Initiate and process provider add, change and termination forms Track, update and audit provider information in database Assist in Corporate audit activities or requests for claims provider set up

Requirements

• High school diploma or equivalent.
• 3+ years of provider data or network administration experience, preferably in managed care.
• Proficient in Microsoft Access and Excel applications.
• This position is remote within the state of New York or the Tri-State area.
• Quarterly and as needed meetings in office are required.

Nice To Haves

• Associate’s degree in related field preferred.
• Experience with data management in large databases, reporting, and analysis preferred.

Responsibilities

• Perform day to day functions to inbound requests and maintain provider database.
• Audit analyses on completed requests and monitor compliance status of submitted requests.
• Analyze inbound request to determine accuracy and route request to provider changes or other cross functional teams
• Maintain provider data management systems for accuracy
• Handle and resolve provider data issues, such as mass change updates, limited reconciliations and direct submissions of urgent requests
• Coordinate provider data between the health plan database and various internal databases
• Participate in reconciliation and provider data projects
• Review, investigate and resolve inquiries regarding loaded providers that may have issues reported from internal and external customers
• Submit daily and weekly internal and external status reports
• Initiate and process provider add, change and termination forms
• Track, update and audit provider information in database
• Assist in Corporate audit activities or requests for claims provider set up

Benefits

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• a flexible approach to work with remote, hybrid, field or office work schedules.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees