Provider Data Specialist #6276
The Provider Data Specialist will be responsible for both performing credentialing and provider support activities as well as maintaining the integrity of the provider and practice data that will further support downstream processes, applications and reports. Extensive use of Microsoft Office Suite is critical. This position must have a keen eye for detail and communicate effectively within all levels. This position will support the credentialing processes by maintaining the various prompts that will monitor and maintain efficiencies. This position must be able to support multiple reporting initiatives both internal and external to adhere to credentialing regulatory deadlines as well ACO requirements.
Education and Experience
An Associate's degree required or a Bachelor's degree preferred with 2-5 years' experience that is related to the duties and responsibilities as specified preferred OR 8 years of related experience in lieu of education.
A minimum of one year of related experience in a health care setting is required; three years of experience is preferred.
Healthcare claims experience preferred
Experience with data analysis and database queries as well as a solid understanding of technology systems preferred
Advanced working knowledge of Microsoft Office and databases preferred
Experience with credentialing software highly preferred.
Professional Association; Affiliation and participation with the National Association Medical Staff Services or the Maine Association Medical Staff Services is preferred.
Regulatory Requirements: General understanding of National Committee for Quality Assurance (NCQA), Joint Commission and Healthcare Facilities Accreditation Program standards. State and federal licensure regulations, particularly as it relates to credentialing and provider data preferred.