Position Purpose: Perform provider data management related activities based on plan and contract specifications and standard business rules – includes data analysis and entry, review of data via internet sites and other systems, and usage of multiple systems and applications to validate data is complete and accurate.
Education/Experience: Associate’s degree, or high school diploma/equivalent and 1+ years of data entry, analysis or customer service experience, preferably with healthcare operations (i.e. claims processing, billing, provider relations or contracting), provider data management, or credentialing in a managed care, insurance, or medical office environment. Experience performing data analysis in Excel or similar tools strongly preferred.
• Enroll providers and practitioners into the provider data management system
• Update provider and practitioners with claims payment and directory information
• Research, review, and make updates within the provider data management system per provider requests
• Perform quality service checks on systemic data, inclusive of claims processing and provider directory information
• Perform research and resolve problems as necessary
EEO:
“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”
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Position Purpose: Perform provider data management related activities based on plan and contract specifications and standard business rules – includes data analysis and entry, review of data via internet sites and other systems, and usage of multiple systems and applications to validate data is complete and accurate.
Education/Experience: Associate’s degree, or high school diploma/equivalent and 1+ years of data entry, analysis or customer service experience, preferably with healthcare operations (i.e. claims processing, billing, provider relations or contracting), provider data management, or credentialing in a managed care, insurance, or medical office environment. Experience performing data analysis in Excel or similar tools strongly preferred.
• Enroll providers and practitioners into the provider data management system
• Update provider and practitioners with claims payment and directory information
• Research, review, and make updates within the provider data management system per provider requests
• Perform quality service checks on systemic data, inclusive of claims processing and provider directory information
• Perform research and resolve problems as necessary
Story Behind the Need
- What is the purpose of this team?
- What is driving this need? (ex. Backfill for FTE or CW, new project, business growth)
- Describe the surrounding team (team culture, work environment, etc.) & key projects.
- Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative?
Provider Data Management (PDM) oversees data for dental providers. The PDM 1 reps oversees provider inquiries, new provider adds and update via request received by various internal departments.
No driving is required.
PDM is currently a team of 13 team members, and we work by market specifics. Each rep is assigned state markets to work and special assignments. Due to recent changes within the company, we will need reps for production and special reports.
Typical Day in the Role
- Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD).
- What are performance expectations/metrics?
- What makes this role unique?
The PDM 1 reps are assigned daily goals at the start of each day. The rep will work on the daily assignments based on level of priority. If there is a large report, we will work on the request as a team. This role is unique because the PDM is seen as an internal customer service for provider data for various departments.
Candidate Requirements
Education/Certification
Required: Diploma/ GED
Preferred: Diploma/GED/Some college coursework/Degree
Licensure
Required: N/A
Preferred: N/A
Years of experience required: Preferred 1-2 years
Disqualifiers: Not being knowledgeable in Microsoft programs
Additional qualities to look for: knowledgeable in systems and programs
- Top 3 must-have hard skills stack-ranked by importance
1
Strong Organizational skills
2
Knowledgeable in excel
3
Adaptable to change
Candidate Review & Selection
- Shortlisting process
- Candidate review & selection
- Interview information
- Onboard process and expectations
Projected Manager Candidate Review Date:
1-2 days post shortlisting
Type of Interviews:
Teams
Required Testing or Assessment (by Vendor):
Typing test, basic computers skills test, etc.
Next Steps
- Do you have any upcoming PTO?
9/18 and 9/20
- Colleagues to cc/delegate
Brian Webber
