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Provider Data Management Specialist

Role overview

Qualifications

  • Bachelor's degree in healthcare administration, information management, or related field, or equivalent experience preferred
  • 2+ years of experience in healthcare data management or similar role required
  • Must have strong proficiency in Excel, including advanced functions, data manipulation, and validation techniques
  • Familiarity with medical terminology, degrees, specialties, and licensing requirements

Responsibilities

  • Process and validate provider data submissions received in Excel format, ensuring accurate system integration
  • Review system updates and error messages post-automation to verify data accuracy
  • Perform manual corrections and updates when automated processes cannot resolve data integrity issues
  • Analyze contract priorities and relationships between provider groups and locations

Key facts

Other skills

  • Microsoft Excel
  • Analytical Thinking
  • Problem Solving
  • Detail Oriented

About the company

Enlyte logo

Enlyte

Computer Software / SaaS

Enlyte is the parent brand of Mitchell | Genex | Coventry, a leader in cost-containment technology, provider and specialty networks, case management services, pharmacy benefit and disability management. The three businesses have recently aligned their joint industry expertise and advanced technology solutions into a combined organization of nearly 6,000 associates committed to simplifying and optimizing property, casualty and disability claims processes and services. For more information, please visit www.enlyte.com.

Company details

IndustryComputer Software / SaaS
Company size5001 - 10000

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Job description

Company Overview:

At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth.

 

Be part of a team that makes a real difference.

Job Description:

The Provider Data Specialist maintains and ensures accuracy of provider network data for delegated group providers. This role is critical in supporting proper claims processing, provider reimbursement, and member access to accurate provider directory information. The position requires strong analytical skills, attention to detail, and proficiency in Excel data manipulation.

 

As a Provider Data Specialist, you will be responsible for maintaining provider data integrity within our systems. You will:

  • Process and validate provider data submissions received in Excel format, ensuring accurate system integration
  • Review system updates and error messages post-automation to verify data accuracy
  • Perform manual corrections and updates when automated processes cannot resolve data integrity issues
  • Manipulate Excel data files to ensure proper formatting for system compatibility
  • Validate incoming provider data against existing system information
  • Maintain data that drives claim pricing and referrals
  • Analyze contract priorities and relationships between provider groups and locations
  • Make informed decisions about data management based on analytical findings
Qualifications:

Education and Experience

  • Bachelor's degree in healthcare administration, information management, or related field, or equivalent experience preferred
  • 2+ years of experience in healthcare data management or similar role required
  • Experience working with provider data management systems preferred

Knowledge, Skills, and Abilities

  • Must have strong proficiency in Excel, including advanced functions, data manipulation, and validation techniques
  • Understanding of healthcare provider networks and relationships
  • Ability to understand contract hierarchies and their impact on provider data management
  • Familiarity with medical terminology, degrees, specialties, and licensing requirements
  • Analytical thinking skills with ability to recognize patterns and make data-driven decisions
  • Attention to detail and commitment to data accuracy
  • Problem-solving skills to address data integrity issues
  • Experience with healthcare information systems preferred
Benefits:

We’re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $20.00 - $25.50 hourly, and will be based on a number of additional factors including skills, experience, and education.  

 

The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.  

 

Don’t meet every single requirement? Studies have shown that women and underrepresented minorities are less likely to apply to jobs unless they meet every single qualification. We are dedicated to building a diverse, inclusive, and authentic workplace, so if you’re excited about this role but your past experience doesn’t align perfectly with every qualification in the job description, we encourage you to apply anyway. You may be just the right candidate for this or other roles.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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