Provider Data Integrity Analyst II

100 Horizon Healthcare Services, Inc; Newark (NJ); On-site; USD 63,000 - 84,000; Full time

Benefits offered by this job

Comprehensive health benefits

Retirement plans

Generous PTO

Incentive plans

Wellness programs

Paid Volunteer Time Off

Tuition reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking an experienced Provider Data Management Specialist to support the Government Programs provider files. You’ll coordinate loading, data quality, and cross‑department collaboration to ensure accurate, timely provider data across systems.

This role requires a minimum of five years in provider data management, strong analytical abilities, and proficiency with MS Office. A valid driver's license and ability to work in NJ are essential.

Qualifications

• High School Diploma or GED required.
• Minimum 5 years relevant work experience in provider data management in Healthcare/insurance.
• A valid driver's license and access to an automobile is required.
• Knowledge of healthcare and provider/claims systems preferred.
• Understanding of indemnity and managed care business and procedures.

Responsibilities

• Maintain Government Programs provider data files accurately and timely.
• Resolve provider data errors by identifying cause and recommending improvements.
• Investigate incidents impacting data integrity and identify trends.
• Assist in specifications for system enhancements and integrations.
• Produce specifications and user testing criteria with proper documentation.
• Evaluate and improve current operating procedures for efficiency and controls.
• Handle important or sensitive projects requiring careful attention.
• Produce departmental reporting for quality, production, and vendor audits.
• Represent the department on workgroups and committees.

Skills

Provider data management

Healthcare knowledge

Windows OS

MS Office suite

Analytical abilities

Attention to detail

Oral and written communication

Independent work

Interdepartmental collaboration

Medical terminology

Education

High School Diploma/GED

Tools

MS Office suite

Windows

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking an experienced Provider Data Management Specialist to support the Government Programs provider files. You’ll coordinate loading, data quality, and cross‑department collaboration to ensure accurate, timely provider data across systems.

This role requires a minimum of five years in provider data management, strong analytical abilities, and proficiency with MS Office. A valid driver's license and ability to work in NJ are essential.