Provider Data & Credentialing Analyst

UCI Health; Orange (CA); On-site; USD 85,000 - 100,000; Full time

Job summary

UCI Health, a major academic health system in California, seeks a Provider Data Analyst to maintain provider databases, ensure data accuracy, and prepare rosters and enrollment reports. The role interfaces with billing and credentialing to resolve denials and improve data integrity across the network.

The ideal candidate has 5+ years of relevant experience, strong English communication, and advanced MS Office/EMR/credentialing software knowledge.

Qualifications

• Minimum of 5 years of relevant experience.
• Excellent written and verbal communication skills in English.
• Detail oriented with strong organizational skills and the ability to manage time efficiently.
• Ability to interpret and convey complex clinical finance information clearly.
• Bachelor's Degree in related area and/or equivalent education/experience.
• Advanced knowledge of healthcare regulations issued by Federal and State entities.
• Advanced knowledge of managed care, provider enrollment/credentialing, and related healthcare concepts.
• Advanced knowledge of MS Office applications, EMR systems, and credentialing software.

Responsibilities

• Maintain the database for hospital, group and billing providers.
• Prepare rosters and reports pertaining to quality, compliance, and enrollment.
• Ensure accuracy and inclusion of all network providers.
• Research claim denials related to provider enrollment/credentialing issues.
• Assist management in achieving department productivity and process improvement goals.

Skills

Database proficiency

Customer service

English communication

Time management

Data analysis

Analytical skills

Clinical finance insight

Interpreting complex information

Education

Bachelor's Degree in related area or equivalent education/experience

Tools

MS Office

EMR systems

Credentialing software

Microsoft Access

Job description

UCI Health, a major academic health system in California, seeks a Provider Data Analyst to maintain provider databases, ensure data accuracy, and prepare rosters and enrollment reports. The role interfaces with billing and credentialing to resolve denials and improve data integrity across the network.

The ideal candidate has 5+ years of relevant experience, strong English communication, and advanced MS Office/EMR/credentialing software knowledge.