Provider Data Integrity Specialist

General Dynamics Information Technology, Inc.; Northern (KY); On-site; USD 55,000 - 85,000; Full time

Benefits offered by this job

Full-flex schedule

401K match

Health benefits

Internal mobility

Education/certs

Career growth

Cutting-edge tech

Paid vacation

Job summary

General Dynamics Information Technology, Inc. is seeking a Provider Data Representative to ensure complete and accurate provider demographic, credentialing, enrollment, roster, and directory data across WTCHP systems.

The role partners with Provider Relations, Credentialing, Provider Data, Claims Operations, and Contracting to support claims payment and network participation. Key duties include directory accuracy, timely updates, roster reconciliation, credentialing support, and generating

Qualifications

• Bachelor's degree preferred.
• 3+ years of experience in provider data, credentialing, enrollment, or health plan operations.
• Strong analytical skills and proficiency in Microsoft Excel.
• Exceptional attention to detail and accuracy.

Responsibilities

• Maintain high accuracy standards for provider directory data.
• Process demographic changes, additions, terminations, and updates within service-level expectations.
• Validate and maintain NPIs, TINs, specialties, practice locations, affiliations, licensure, and EFT data.
• Reconcile provider rosters against credentialing, enrollment, claims, and directory systems.
• Validate provider demographic data required for onboarding, credentialing, and recredentialing.
• Identify data issues impacting claims adjudication, reimbursement, or provider participation.
• Generate dashboards, productivity logs, discrepancy reports, and data quality metrics.
• Communicate data requirements, corrections, and discrepancies to credentialing, enrollment, and provider relations teams.
• Recommend workflow enhancements, automation opportunities, and system updates.

Skills

Data governance & quality management

Analytical thinking

Process improvement

Attention to detail

Written & verbal communication

Collaboration & teamwork

Education

Bachelor's degree preferred

Tools

Microsoft Excel

Job description

General Dynamics Information Technology, Inc. is seeking a Provider Data Representative to ensure complete and accurate provider demographic, credentialing, enrollment, roster, and directory data across WTCHP systems.

The role partners with Provider Relations, Credentialing, Provider Data, Claims Operations, and Contracting to support claims payment and network participation. Key duties include directory accuracy, timely updates, roster reconciliation, credentialing support, and generating