Provider Data Management Analyst 1

Randstad Digital Americas is recruiting for a Provider Data Management Analyst 1 to support provider data integrity across assigned state markets. The role handles provider enrollment, data updates, validation, quality checks, and discrepancy resolution for claims processing and provider directories.

Responsibilities:

• Perform provider data analysis, enrollment, and system updates to ensure data accuracy for claims processing and provider directories
• Enroll providers and practitioners into provider data management systems following contract guidelines
• Update provider demographic, claims payment, and directory information based on incoming internal requests
• Conduct data analysis using internet sources and internal applications to validate record completeness
• Perform quality service checks on systemic data, claims processing rules, and directory listings
• Research and resolve provider data discrepancies to support assigned state market teams

Requirements:

• High School Diploma or GED required
• 1+ years of data entry, data analysis, or customer service experience
• strong proficiency in Microsoft Office, with emphasis on MS Excel data manipulation
• Exceptional organizational capabilities, system adaptability, and attention to detail
• Years of experience: 2 years
• Experience level: Experienced
• Associate's degree or college coursework preferred
• Preferred experience in healthcare operations, claims, billing, provider relations, or credentialing