Provider Data Steward: Health Plan Data & Compliance

Sutherland; Atlanta (GA); On-site; USD 55,000 - 75,000; Full time

Job summary

We are seeking a Provider Data Management (PDM) Specialist to oversee and maintain provider records within our health plan systems. This role involves entering and updating provider data and demographic information in internal systems, while ensuring accuracy and compliance with policies and regulations.

The ideal candidate should possess strong attention to detail, analytical skills, and experience working with provider networks and healthcare databases.

Qualifications

• Excellent written communication skills in English with clarity and accuracy.
• Strong reading and listening comprehension in English to process requests.
• Well-developed analytical, logical, and organizational abilities for problem-solving.
• Ability to prioritize tasks for timely processing of intakes.
• Keen attention to detail with ability to multitask in a fast-paced environment.
• Strong customer focus and delivering exceptional service and support.
• Proficiency in Microsoft Office Suite and navigating web-based applications.
• Typing speed of at least 40 words per minute, with accuracy and efficiency.

Responsibilities

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

Skills

Data entry

Attention to detail

Analytical thinking

Multitasking

Customer focus

MS Office

Typing 40 WPM

Tools

Microsoft Office Suite

Web-based applications

Job description

We are seeking a Provider Data Management (PDM) Specialist to oversee and maintain provider records within our health plan systems. This role involves entering and updating provider data and demographic information in internal systems, while ensuring accuracy and compliance with policies and regulations.

The ideal candidate should possess strong attention to detail, analytical skills, and experience working with provider networks and healthcare databases.