Provider Data & Directory Engagement Specialist

Peach State Health Plan, Inc.; Nebraska; Remote; USD 32,000 - 55,000; Full time

Job summary

Centene is hiring for a remote Provider Data Specialist who ensures accurate provider setup in the information system for state reporting, claims, and directories. You will support provider data issues, respond to inquiries, and process add/change/termination forms with cross-department collaboration.

The role requires an associate degree and relevant healthcare experience. The position is remote but requires availability during Eastern Time business hours, with pay range disclosed and benefits

Qualifications

• Associate's degree required; three years of experience in managed care, medical claims, or similar.
• Experience with provider data, claims, and enrollment processes preferred.
• Familiarity with Medicare/Medicaid a plus.

Responsibilities

• Provide provider data support to resolve issues in the provider information system.
• Research and respond to provider related inquiries.
• Submit provider data entries for demographic changes and add/change/terminate forms.
• Create and maintain provider directories and spreadsheets.
• Audit provider data and track changes across products.
• Coordinate with departments on cross-functional tasks and provider orientations and trainings.

Skills

Claims processing

Billing

Coding

Customer service

Education

Associate's degree

Job description

Centene is hiring for a remote Provider Data Specialist who ensures accurate provider setup in the information system for state reporting, claims, and directories. You will support provider data issues, respond to inquiries, and process add/change/termination forms with cross-department collaboration.

The role requires an associate degree and relevant healthcare experience. The position is remote but requires availability during Eastern Time business hours, with pay range disclosed and benefits