Provider Data & Credentialing Specialist – Remote

CareAllies, Inc.; El Paso (TX); Remote; USD 26,000 - 47,000; Full time

Job summary

CareAllies, Inc. is seeking a provider data analyst responsible for analyzing, researching, and applying business rules to provider information used for claims processing, membership assignment, and directory accuracy.

You will review contracting, credentialing, and maintenance of provider data across all lines of business while collaborating with cross-functional teams. Remote work is possible for qualified candidates nationwide within the continental U.S.

Qualifications

• 2 years of college and/or 2 years of relevant experience.
• Written and verbal communication skills to interact with internal and external customers.
• Analytical and quantitative skills.
• Ability to take initiative and work independently.
• Bilingual Spanish highly preferred, but not required.
• Experience using Salesforce a plus.

Responsibilities

• Analyze, research, and apply business rules to provider data updates for claims processing, membership assignment, and directory accuracy.
• Review contracting, credentialing, and maintenance of provider data across all lines of business.
• Serve as liaison between Network Contracting, Credentialing, Product Development, Legal, Marketing, IT, Government Programs, and other partners on network activities.
• Support quality initiatives to ensure data accuracy and participate in internal provider meetings and work groups.

Skills

Analytical & quantitative skills

Written & verbal communication

Initiative & independence

Spanish language (preferred)

Education

2-year college or equivalent experience

Tools

Salesforce

Job description

CareAllies, Inc. is seeking a provider data analyst responsible for analyzing, researching, and applying business rules to provider information used for claims processing, membership assignment, and directory accuracy.

You will review contracting, credentialing, and maintenance of provider data across all lines of business while collaborating with cross-functional teams. Remote work is possible for qualified candidates nationwide within the continental U.S.