Provider Data Management Analyst III — Precision & Impact

UST; Taguig; On-site; PHP 450,000 - 650,000; Full time

Job summary

UST in the Philippines is seeking a Provider Data Management (PDM) Analyst to review, validate, update, and maintain accurate provider information within a BPM environment, following approved processes and procedures.

The role supports outreach verification, returned mail, credentialing record updates, and PIMS claim-related provider setup, while meeting quality, productivity, turnaround time, and SLA requirements.

Qualifications

• Bachelor's degree required.
• Experience in US healthcare provider data management, credentialing, or provider operations preferred.
• Strong attention to detail and documentation accuracy.

Responsibilities

• Review provider update requests from preferred and non-preferred providers and update demographics, addresses, specialties, affiliations, and practice locations.
• Retain provider correspondence, notes, system records, and supporting evidence while escalating incomplete or conflicting information.
• Perform activities according to BPM workflows, process controls, and guidelines.
• Support outreach verification by contacting providers via email or phone and documenting outcomes.
• Handle returned mail cases, validate addresses, update systems, and escalate unresolved discrepancies.
• Update credentialing records per policies, support recredentialing activities and primary source verification.
• Review pended claims to load missing provider information and ensure downstream processing.
• Maintain trackers, dashboards, and status records and participate in process improvement activities.

Skills

Microsoft Excel

Provider Data Management

Healthcare Systems

Claims Management

Education

Bachelor's degree

Job description

UST in the Philippines is seeking a Provider Data Management (PDM) Analyst to review, validate, update, and maintain accurate provider information within a BPM environment, following approved processes and procedures.

The role supports outreach verification, returned mail, credentialing record updates, and PIMS claim-related provider setup, while meeting quality, productivity, turnaround time, and SLA requirements.