Provider Data Specialist

Provider Data Specialist

Our client, a health insurance company, is looking for a Provider Data Specialist for their Detroit, MI/Hybrid location.

Responsibilities:

• The original scope for bringing specialist onboard is to work on PIAI projects provider data clean up measures.
• Upon completion of projects, we are finding that these projects are turning into ongoing processes.
• For example: State of Michigan BH (SOM BH) Audit provider outreach, Provider Data Confidence Value (PDCV) audit provider outreach, return mail, facility attestation noncompliant providers, daily CAQH Directory Verification task.
• Validating provider information through auditing processes to reduce and eliminate inaccurate data for accuracy and auditing purposes.
• Increase provider accuracy on members website by eliminating outdated information.
• Perform several outreaches daily to providers across Michigan to verify certainty of demographic information such as phone numbers, address, accepting new patients.
• Review and process results of audits for validity in collaboration with leadership to ensure accurate data is uploaded into database.

Requirements:

• Excel
• Access
• Outlook
• PORTICO
• SF MACESS
• FACETS
• High school diploma
• 3 to 5 years experience

Why Should You Apply?

• Health benefits
• Referral program
• Excellent growth and advancement opportunities

ICONMA is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to any status protected by applicable law.