Provider Data Services Specialist

Role Overview

• Compare and contrast the provider system with network data and regulatory sources
• Manage provider records for accuracy in the provider directory
• Review and submit requests to update the provider module for adds/changes
• Research updates to ensure compliance with CMS and AHCCCS regulations
• Utilize standard data elements for provider data to feed member directories and regulatory reports

Requirements

• 1-2 years of experience in customer service
• Must reside in Arizona
• Strong analytical and written/oral communication skills
• 1-2 years of experience with SQL
• 1-2 years of experience in Microsoft Excel
• Previous experience working with QNXT
• Previous experience with medical claims processing
• Previous knowledge of medical billing

Tech Stack

• SQL

Benefits

• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs
• other resources, based on eligibility