Provider Network Data Integrity Specialist

PacificSource; United States; À distance; USD 36 000 - 57 000; Plein temps

Résumé du poste

PacificSource is seeking a Provider Network Maintenance Associate to maintain provider data accuracy across systems, support credentialing and contract data, and ensure compliance with regulatory requirements.

You will collaborate with Provider Relations, Credentialing, Contracting, and other teams, perform regular data audits, verify licensure and eligibility, and pursue process improvements to boost data quality and timely reimbursements.

Qualifications

• Minimum 2 years of experience in an office environment.
• Healthcare data management experience preferred.
• Familiarity with provider network operations including credentialing, contracting or reimbursement processes is a plus.
• Proficient data entry, typing, and basic computer skills.

Responsabilités

• Enter and update provider demographic, credentialing, and contract information in systems accurately.
• Process provider additions, terminations, and changes to maintain data integrity.
• Audit provider data for accuracy and regulatory compliance.
• Assist in managing provider directories.
• Verify licensure and Medicare/Medicaid eligibility for compliance.

Connaissances

Fast data entry

Typing & 10-key

Written & verbal communication

Organizational skills

Problem solving

Teamwork

Medical terminology CPT/ICD-10

Formation

High School Diploma or equivalent

Associate’s degree preferred

Bachelor’s degree preferred

Description du poste

PacificSource is seeking a Provider Network Maintenance Associate to maintain provider data accuracy across systems, support credentialing and contract data, and ensure compliance with regulatory requirements.

You will collaborate with Provider Relations, Credentialing, Contracting, and other teams, perform regular data audits, verify licensure and eligibility, and pursue process improvements to boost data quality and timely reimbursements.