Provider Data Analyst

HireTalent; Franklin (TN); Remote; USD 45,000 - 70,000; Full time

Job summary

An innovative firm is seeking a detail-oriented professional to join its Provider Data team. This remote role focuses on delivering quality assurance for reimbursement accuracy, requiring strong knowledge of medical coding and fee schedules. The ideal candidate will have at least five years of experience in provider data, showcasing exceptional organizational skills and the ability to mentor junior staff. If you thrive in a dynamic environment and are passionate about quality assurance, this opportunity is perfect for you.

Qualifications

• 5+ years of experience in provider data and quality assurance.
• Strong knowledge of medical coding and reimbursement types.

Responsibilities

• Ensure timely quality assurance for accurate reimbursement.
• Provide guidance and coaching to junior team members.

Skills

Organizational Skills

Provider Data Experience

Quality Assurance

Medical Terminology

ICD-10 Coding

CPT Coding

HCFA Coding

Education

High School Diploma

Tools

Microsoft Office Products

Smartsheet

Plexis Claims Management Platform

Job description

Delivers professional activities in the Provider Data job family. Responsible for accurate, timely quality assurance for accurate reimbursement based on provider contract and area fee schedules. Provides quality assurance error reporting to data entry specialists and supervisor. Interprets update requests and coordinates with internal and external customer to clarify and complete. Applies standard techniques and procedures to routine instructions that require professional knowledge in specialist areas. Provides standard professional advice and creates initial reports/analyses for review. May provide guidance, coaching, and direction to more junior members of the team in Provider Data. Qualifications and requirements include: High School diploma; at least 5 or more years of working knowledge with strong knowledge in flat fee, RBRVS, "percentage of" fee schedule reimbursement types, medical terminology, ICD-10 and CPT and HCFA coding.
This position includes fiduciary duty or access to financial systems. This is a remote role.

Strong organizational skills
Provider Data Experience
Previous Quality Assurance experience
Microsoft Office Products
Smartsheet
Plexis Claims Management Platform experience a plus