Provider Data Integrity & Credentialing Specialist

American Health Plans; Franklin (TN); Remote; USD 42,000 - 62,000; Full time

Job summary

American Health Plans seeks a Provider Data Specialist to ensure accurate provider demographics and payment methods across systems and to support reporting to relevant agencies. The role includes credentialing data tasks, data extraction, and maintaining data integrity.

Typical work is performed from home with 8:00 AM–5:00 PM hours negotiable, and some travel may be required to the corporate office if located nearby.

Qualifications

• Education: High School Diploma / GED; College coursework/degree preferred; Bachelor’s degree advantageous.
• Experience: Data entry in a deadline-driven environment; Credentialing experience beneficial.

Responsibilities

• Maintain provider demographic information through contracting submissions and updates.
• Review data and correct errors as received.
• Extract and report data for analyses.
• Coordinate with IT projects for reporting and provider directory support.
• Assist Credentialing Committee meetings and related communications.

Skills

Typing 40+ wpm

Data entry

Prioritize workload

Communication

Detail oriented

Education

High School Diploma / GED

College Coursework / Degree preferred

Bachelor's degree

Tools

Microsoft Office (Outlook, Excel, Word)

Job description

American Health Plans seeks a Provider Data Specialist to ensure accurate provider demographics and payment methods across systems and to support reporting to relevant agencies. The role includes credentialing data tasks, data extraction, and maintaining data integrity.

Typical work is performed from home with 8:00 AM–5:00 PM hours negotiable, and some travel may be required to the corporate office if located nearby.