[Hiring] Provider Data Maintenance Specialist @Health Care Service Corporation

Role Description

This position is responsible for analyzing, researching, and applying business rules to complete requests received from providers regarding adds/deletes/changes to their information used for claims processing, membership assignment, and directory purposes.

• Review contracting, credentialing, and maintenance of Provider Data to support Claim’s payment, Marketing, Membership, and Network Contracting across all lines of business.
• Provide accurate and timely administration of provider contracts, rosters, and requests supporting quality initiatives to ensure data accuracy.
• Participate in internal provider meetings and work groups.
• Research problems related to provider credentialing, data, and network participation.
• Work as a Liaison between Network Contracting, Enterprise Credentialing, Product Development, Special Investigations Department, Legal, Marketing, Full Service Units, ITG, Government Programs, and other business partners on network activities.

*** The ideal candidate for this position must reside within a reasonable commute distance to the El Paso, Texas local office.

Qualifications

• 2 years of college and/or 2 years of relevant experience.
• Written and verbal communication skills to interact with internal and external customers.
• Analytical and quantitative skills.
• Ability to take initiative and work independently.

Requirements

• Working knowledge of Professional Provider Credentialing Process (preferred).
• 1 year of experience on the Provider Data (preferred).
• Experience with Microsoft Office applications including Excel, Access, and PowerPoint (preferred).
• Bilingual Spanish highly preferred, but not required.
• Experience using SalesForce a plus (preferred).

Benefits

• Health and wellness benefits.
• 401(k) savings plan.
• Pension plan.
• A minimum of 15 days of paid time off.
• Paid parental leave.
• Disability insurance.
• Supplemental life insurance.
• Employee assistance program.
• Paid holidays.
• Tuition reimbursement.
• Other incentives.

Pay Transparency Statement

The salary offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and conditions of the plan.

Min to Max Range: $19.13 - $34.17. Exact compensation may vary based on skills, experience, and location.