Provider Data Specialist

Managing provider data for a national network, the full-time Provider Data Specialist will be responsible for educating, verifying, and accurately maintaining demographic and payee data for over 80,000 ophthalmology and optometry practitioners, while working remotely. Key responsibilities Create and manage records for contracted and non-contracted providers in the provider databases, ensuring accuracy for claims processing and authorizations Review and update existing provider, office, and payee records based on documentation and internal requests Conduct audits and resolve data discrepancies while providing education to providers and internal departments about the importance of accurate provider data Required qualifications 4-5 years of experience in provider data management, credentialing, or related roles within a managed care organization Associate or Bachelor's degree preferred, or equivalent combination of education and experience Experience managing sensitive information, including Protected Health Information (PHI) and Personal Identifiable Information (PII) Knowledge of CMS Provider Directory regulations and experience with healthcare providers Proficiency in Microsoft Office Suite, including Excel, Word, Access, and PowerPoint