Provider Data Maintenance Spec

About the role

At CareAllies , our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Job Summary

This position is responsible for the analyzing, researching, and applying business rules to complete requests received from providers regarding adds/deletes/changes to their information used for claims processing, membership assignment, and directory purposes.

Review contracting, credentialing, and maintenance of Provider Data to support Claim’s payment, Marketing, Membership and Network Contracting across all lines of business.

This includes providing accurate and timely administration of provider contracts, rosters and requests supporting quality initiatives to ensure data accuracy.

Responsibilities including internal provider meetings and work groups, researching problems related to provider credentialing, data and network participation.

Includes working as a Liaison between Network Contracting, Enterprise Credentialing, Product Development, Special Investigations Department, Legal, Marketing, Full Service Units, ITG, Government Programs, and other business partners on network activities.

*** The ideal candidate for this position must reside within a reasonable commute distance to the El Paso, Texas local office.

Required Job Qualifications:

* 2 years of college and/or 2 years of relevant experience

* Written and verbal communication skills to interact with internal and external customers

* Analytical and quantitative skills

* Ability to take initiative and work independently

Preferred Job Qualifications:

* Working knowledge of Professional Provider Credentialing Process

* 1 year of experience on the Provider Data

* Experience with Microsoft Office applications including Excel, Access, and Power Point

* Bilingual Spanish highly preferred, but not required

* Experience using SalesForce a plus

This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii .

EEO Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

Pay Transparency Statement:

At CareAllies, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, a minimum of 15 days’ of paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for full-time employees .

The salary offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Min to Max Range:

$19.13 - $34.17

Exact compensation may vary based on skills, experience, and location.

Posting text as published by Hcsc.

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Location as listed

National Remote, United States of America

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