Healthcare Data Integrity & Configuration Manager

Provider Network Solutions LLC; Miami (FL); On-site; USD 100,000 - 150,000; Full time

Job summary

Provider Network Solutions LLC in Florida seeks a Configuration and Data Integrity Manager to oversee provider configuration, data integrity, and claims processing. You will coordinate with internal departments and external organizations to ensure secure data exchanges, reliability, and availability of network data.

Responsibilities include configuring benefits, loading contracts, testing configurations, and auditing data quality.

Qualifications

• 3-5 years of Claims Processing experience required.
• 1-2 years’ experience in healthcare data management.
• Broad knowledge of medical terminology, customer service, claims processing and/or cost containment.

Responsibilities

• Responsible for benefit configuration and contract rate loads in the TPA system.
• Quality control of all provider data, fee schedules, and network assignments.
• Collaborate with provider relations and credentialing to manage configuration and data integrity.
• Provide system configuration support in response to changing business needs.
• Analyze and resolve claims workflow concerns related to benefit and contract configuration.

Skills

Claims processing

Data integrity

Healthcare terminology

Tools

Microsoft Office Suite

Job description

Provider Network Solutions LLC in Florida seeks a Configuration and Data Integrity Manager to oversee provider configuration, data integrity, and claims processing. You will coordinate with internal departments and external organizations to ensure secure data exchanges, reliability, and availability of network data.

Responsibilities include configuring benefits, loading contracts, testing configurations, and auditing data quality.