Job Title: Provider Data Entry Specialist
Work Schedule: 7:00 AM - 4:00 PM or 7:30 AM - 4:30 PM CST
** Applicants must be in Eastern Time Zone. Priority to candidates in Rockville Maryland and surrounding areas
Job Type: This is a direct hire position
Pay: $26.00 per hour
Benefits: Medical, Dental, Vision, PTO - 15 days; 401(k) with match.

Job Summary:

The Provider Coordinator plays a crucial role in ensuring the accuracy and integrity of provider demographic and contract affiliation information within the health plan system. This role demands meticulous attention to detail and efficiency in processing incoming requests to optimize claims adjudication.

Essential Functions:

In this role, you will receive provider information from external sources for system updates and apply your knowledge and experience to validate the provided information. Accurate data entry and maintenance of provider records in the computer system are vital aspects of this position, emphasizing precision and timeliness. Regular audits of loaded provider records are conducted to ensure both quality and financial accuracy, with documented feedback provided when necessary.

You will actively support system/health plan integration efforts and be responsible for training both existing staff and new hires. Additionally, you will assist in system-related testing activities.

Knowledge/Skills/Abilities:

The successful candidate will demonstrate exceptional attention to detail, proficiency in data entry with a strong focus on timeliness, and excellent project management skills. Meeting deadlines and effectively managing time are essential attributes. Proficiency in Microsoft Office applications, including Outlook, Word, Excel, and Access, is required. A willingness and ability to learn internal systems, particularly QNXT, is expected.

Strong verbal and written communication skills are essential, along with adherence to Managed Care Organization's policies and confidentiality requirements. Maintaining reliable attendance based on the agreed-upon schedule is mandatory. Understanding and compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations is critical. The ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers is also vital.

Required Education and Experience:

To qualify for this role, you must possess a High School Diploma or equivalent GED.
Candidates must have 1 years of managed care experience and/or medical office experience with coding or credentialing experience.
Must live in MD/DC/VA
You must have at least one year of medical office experience for this role.

The Provider Coordinator position offers a unique opportunity to contribute significantly to the accuracy and efficiency of our health plan system. If you are skilled in meticulous data entry and dedicated to maintaining high data quality standards, we encourage you to apply for this position.