Provider Integration Data Entry Specialist

The Provider Integration Data Specialist enters, supports and maintains provider data from multiple sources for all lines of business in multiple data sources. This role processes inquires from internal customers, and external customers (Providers, Provider Entities, Third Party Administrator Groups, and Employer Groups). This role provides excellent service to internal and external customers through demonstrated commitment to Network Health's Mission, Values and business operation plans.

Job Responsibilities:

• Ability to multi-task to ensure all provider data is loaded into any/all data sources while meeting audit and regulatory requirements.
• Must be able to prioritize work to ensure required daily and ongoing issues are completed within the timeframe requirements of NCQA and CMS.
• Research, analyze, and respond to providers' inquiries, as well as issues raised by internal personnel, providing timely solutions to problems while also handling inquiries with responses communicated verbally or in written format. The work involves the necessity for accuracy, discretion and requires analysis and research of incomplete, conflicting or complex information.
• Responsible for thorough investigation of data discrepancies. This includes good communication, analyzing data, critical thinking and problem solving.
• Ensure accuracy of provider data in multiple systems and respond to inquiries timely/accordingly.
• Efficient in the use of multiple software/systems (e.g. QNXT, Echo, QuickBase, Adobe Acrobat, Microsoft Office Word/Excel). Ability to establish a rapport and professionally work with a broad spectrum of internal and external customers, maintaining proper voice tone and language in accordance with the caller's level of understanding and to ensure positive customer perception.
• Ability to work as a team member, as well as working with other internal departments, independently demonstrating a high level of initiative and self-direction with limited assistance.
• Ensure the protection of NHP/NHI/NH_TPA/NHIC hardware, software, information and data complying with NHP/NHI/NH_TPA/NHIC security requirements and policies.
• Ensure the protection of the privacy and confidentiality of data.
• Continuously look for process improvement opportunities.
• Other duties and responsibilities as assigned.

Job Requirements:

• High school diploma, or equivalent.
• Associate degree or related experience preferred.
• Two or more years experience in the insurance industry.
• At least two years work experience working with data entry, changes and maintenance

Job Skills:

• Knowledge of insurance principles.
• Knowledge of databases, word processing and spreadsheet applications (Microsoft Word and Excel).
• Ability to learn software and appropriate standards related to CMS, NCQA.
• PC proficient; data entry skills with a high degree of accuracy.

We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce.