Provider Data Quality
Performs provider data management related activities based on plan and contract specifications and standard business rules.
- Associates degree or high school diploma/equivalent and two years experience working in health care operations, or equivalent experience with credentialing, claims, and provider data management.
- Excellent communication and writing skills.
- Accurate data entry skills and experience in personal computer software applications such as Microsoft Office (Excel, Word) and Adobe Acrobat with the ability to learn applications that support credentialing and provider data management processes.
- General understanding of managed care plans and health insurance.
- Critical thinking abilities along with the ability to work independently.
- Proven time management and organizational skills.
- College degree perferred.
- Related certification.
- Knowledge of medical coding and terminology.
- Experience with claims processing data system.