The Provider Data Specialist supports healthcare operations by maintaining accurate provider data and assisting with credentialing updates. This role helps ensure provider information is current and properly reflected in internal databases, and works closely with internal teams and external partners to resolve issues as they arise.
Responsibilities
- Maintain and update provider demographics, tax IDs, certifications, and other relevant documentation
- Enter and manage data related to provider credentialing and contracts
- Make outbound calls as needed to verify information or resolve discrepancies
- Support providers and internal staff by explaining data requirements and addressing questions
- Research and help resolve issues related to claims, eligibility, and provider recordsÂ
Qualifications
- High School Diploma or equivalentÂ
- 1+ year of healthcare experience in one or more of the following areas: provider data, network support, credentialing assistance, claims processing, or provider services
- Strong data entry skills with high attention to detail
- Familiarity with managed care and provider reimbursement preferred
- Strong problem-solving and communication skills
- Experience using provider data systems or similar platforms a plusÂ