Provider Services Associate II

UST; Taguig; On-site; PHP 360,000 - 540,000; Full time

Job summary

UST is seeking a data validation professional for BPM operations focused on healthcare provider information. You will review, validate, and correct provider records to meet quality and SLA targets while ensuring HIPAA compliance.

The role requires 3+ years in BPM/BPO or data processing, strong attention to detail, and English communication skills. Onsite night shift with opportunities to collaborate across teams and drive accurate data management.

Qualifications

• 3+ years of experience in BPM/BPO operations or data processing, preferably in US healthcare or health insurance.
• Good understanding of transaction processing, SLA, quality, and productivity metrics.
• Strong attention to detail and accuracy.
• Good analytical and problem-solving skills.
• Working knowledge of MS Office and data processing applications.
• Good verbal and written communication skills in English.
• Ability to work effectively in a team and handle process volumes within defined timelines.
• Amenable to work onsite and nightshift.

Responsibilities

• Review provider information for demographics, credentials, network status, and payment-related details; identify discrepancies.
• Update and correct provider records based on SOPs.
• Complete transactions within SLA, productivity, turnaround time, and quality standards.
• Perform QA checks to ensure data completeness and accuracy.
• Research data discrepancies and escalate complex cases as needed.
• Maintain records of transactions, corrections, and outcomes as required.
• Follow HIPAA and data privacy/compliance requirements.
• Coordinate with team members and stakeholders for timely issue resolution.
• Ust values alignment with Integrity, Customer Centricity, Innovation, Collaboration, Excellence, and Respect.

Skills

Attention to detail

Data processing

English communication

Team collaboration

HIPAA compliance

Education

College degree (advantage but not required)

Tools

MS Office

Data processing software

Job description

Role Description

Responsible for reviewing, validating, and correcting healthcare provider information as part of BPM operations. The role focuses on maintaining accurate provider data, meeting defined quality and productivity targets, and completing assigned activities within established SLAs and process guidelines.

Role Description

Responsible for reviewing, validating, and correcting healthcare provider information as part of BPM operations. The role focuses on maintaining accurate provider data, meeting defined quality and productivity targets, and completing assigned activities within established SLAs and process guidelines.

Key Roles and Responsibilities

• Provider Data Validation: Review provider information such as demographics, credentials, network status, and payment-related details and identify discrepancies or incomplete information.
• Data Correction: Update and correct provider records accurately based on defined process guidelines and standard operating procedures.
• Process Execution: Complete assigned transactions within agreed SLA, productivity, turnaround time, and quality standards.
• Quality Assurance: Perform required quality checks to ensure provider information is complete and accurate.
• Issue Resolution: Research data discrepancies, identify recurring issues, and escalation complex cases to the appropriate team or supervisor.
• Documentation: Maintain accurate records of transactions, corrections, and outcomes as required by the process.
• Compliance: Follow applicable healthcare data privacy, security, and compliance requirements, including HIPAA.
• Collaboration: Coordinate with team members, leads, and other stakeholders for timely resolution of provider data issues.
• UST Values: Uphold UST values of Integrity, Customer Centricity, Innovation, Collaboration, Excellence, and Respect.

Required Skills And Qualifications

• Experience: 3+ years of experience in BPM/BPO operations or data processing, preferably in the US healthcare or health insurance domain.
• Good understanding of transaction processing, SLA, quality, and productivity metrics.
• Strong attention to detail and accuracy.
• Good analytical and problem-solving skills.
• Working knowledge of MS Office and data processing applications.
• Good verbal and written communication skills in English.
• Ability to work effectively in a team and handle process volumes within defined timelines.
• Amenable to work onsite and nightshift

Education

• College degree an advantage but not required

Skills

HIPAA, Healthcare Systems, Business Operations, Compliance Management