Provider Data Management Analyst II

Centene Corporation

1d•$23 - $40

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 provider data management related activities based on plan and contract specifications and standard business rules – includes data analysis and entry, review of data via internet sites and other systems, usage of multiple systems and applications to validate data is complete and accurate, and investigation and resolution of data issues. Set up and perform facility (hospitals and clinics) enrollment in the provider data management system Enroll providers and practitioners in the provider data management system Update facilities, providers, and practitioners with claims payment information Research, review and make updates within the provider data management system per provider requests Perform quality service checks on systemic data, inclusive of claims processing and provider directory information Perform research and resolve problems as necessary Train and mentor Provider Data Management Analyst I

Requirements

Bachelor’s degree in a related field, or Associate’s degree in related field or equivalent experience and 2+ years of provider data management, credentialing or healthcare operations (i.e. claims processing, billing, provider relations or contracting) experience, preferably in a managed care, insurance, or medical office environment.
Experience performing data analysis in Excel or similar tools strongly preferred.

Responsibilities

Perform provider data management related activities based on plan and contract specifications and standard business rules
Data analysis and entry
Review of data via internet sites and other systems
Usage of multiple systems and applications to validate data is complete and accurate
Investigation and resolution of data issues
Set up and perform facility (hospitals and clinics) enrollment in the provider data management system
Enroll providers and practitioners in the provider data management system
Update facilities, providers, and practitioners with claims payment information
Research, review and make updates within the provider data management system per provider requests
Perform quality service checks on systemic data, inclusive of claims processing and provider directory information
Perform research and resolve problems as necessary
Train and mentor Provider Data Management Analyst I