Provider Data Integrity Specialist

Sutherland; Oregon; Hybrid; USD 60,000 - 90,000; Full time

Job summary

Sutherland is seeking a Provider Data Management (PDM) Specialist to oversee and maintain accurate provider records in our health plan systems. You will enter, update, and validate provider data and demographics, ensuring compliance with CMS, HIPAA, and regulations.

The role requires strong attention to detail, analytical skills, and experience with provider networks. You will conduct audits, load data per guidelines, and manage daily activities to meet targets, working independently with

Qualifications

• Accurate data entry and record maintenance.
• Experience with provider networks and healthcare databases.
• Ability to comply with CMS, HIPAA, and state/federal regulations.
• Excellent English communication and attention to detail.

Responsibilities

• Accurately enter, update, and maintain provider information in internal systems.
• Validate provider credentialing data, contracts, and demographic data to ensure accuracy.
• Ensure provider records are in compliance with CMS, HIPAA, and state/federal regulations.
• Conduct routine audits and reconciliations to maintain data integrity.
• Review and load the required data into the health plan system as the process guidelines require.
• Manage and monitor daily activities and meet the set targets.
• Work independently and complete the tasks in established timeframe with minimal supervision.

Skills

Attention to detail

Analytical thinking

English communication

Time management

Multitasking

Customer focus

Typing 40 WPM

Microsoft Office

Data entry accuracy

Tools

Microsoft Office Suite

Web-based applications

Secure network access

Job description

Sutherland is seeking a Provider Data Management (PDM) Specialist to oversee and maintain accurate provider records in our health plan systems. You will enter, update, and validate provider data and demographics, ensuring compliance with CMS, HIPAA, and regulations.

The role requires strong attention to detail, analytical skills, and experience with provider networks. You will conduct audits, load data per guidelines, and manage daily activities to meet targets, working independently with