Provider Data Steward | Compliance & Records Expert

Sutherland Global; Atlanta (GA); On-site; USD 60,000 - 80,000; Full time

Job summary

Sutherland Global is seeking a Provider Data Management (PDM) Specialist to oversee and maintain accurate provider records within our health plan systems. The role focuses on entering, updating, and validating provider data to ensure regulatory compliance.

The ideal candidate will have strong attention to detail, analytical skills, and experience with provider networks and healthcare databases. Ability to work independently and meet deadlines is essential.

Qualifications

• Accurately enter, update, and maintain provider information in internal systems to ensure data integrity.
• Validate provider credentialing data, contracts, and demographics for accuracy and completeness.
• Maintain compliance with CMS, HIPAA, and state/federal regulations.
• Conduct routine audits and reconciliations of provider data to ensure accuracy.

Responsibilities

• Enter and update provider information in internal systems.
• Validate credentialing, contracts, and demographic data for accuracy.
• Ensure data complies with CMS, HIPAA, and regulatory requirements.
• Perform routine audits and reconciliations to maintain data integrity.
• Review and load required data into health plan systems per guidelines.
• Prioritize tasks to meet targets and deadlines.
• Work independently with minimal supervision.

Skills

Data entry accuracy

Analytical thinking

English communication

Time management

Job description

Sutherland Global is seeking a Provider Data Management (PDM) Specialist to oversee and maintain accurate provider records within our health plan systems. The role focuses on entering, updating, and validating provider data to ensure regulatory compliance.

The ideal candidate will have strong attention to detail, analytical skills, and experience with provider networks and healthcare databases. Ability to work independently and meet deadlines is essential.