Provider Data Coordinator

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
• Employer-matched retirement saving funds
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities

What You Will Do

• Maintains current provider demographic information in databases (Salesforce, Facets, Guiding Care) via data entry. Works with vendors to ensure data consistency and quality.
• Works system errors and exceptions to maintain clean provider data across all systems.
• Facilitates outreach to providers to test integrity of online provider demographic information. Updates provider data as needed to ensure quality.
• Monitors updates for provider data intake pathways, including but not limited to, Portal, Online form, mail, fax and email. Coordinates with providers and updates record accordingly.
• Assists with Claim intake and creates out of network profiles as necessary.
• Interfaces internally to investigate provider issues and assist with customer resolution.
• Processes return mail and return checks; logs data and updates provider record to remediate return mail.
• Monitors and resolves Provider Claim Pend queue. Escalates issues as appropriate.
• Obtains required documentation from providers necessary for the establishment of a complete provider record on VNS Health systems, e.g. IRS W9 form.
• Provides administrative support to the department including filing, mail distribution, preparing reports, and documenting inquiries and requests.
• Participates in special projects and performs other duties as assigned.

Education:

• Associate's Degree in Business, Communications or related field or the equivalent work experience required
• Bachelor's Degree in Business, Communications or related field or the equivalent work experience preferred

Work Experience:

• Minimum two years experience in health care Payer environment, Credentialing or Provider Data required
• Excellent written/oral communication and interpersonal skills required
• Proficient in Microsoft Office Applications, including Excel required
• Experience in administering provider relationships preferred