[Hiring] Provider Data Specialist I @CareOregon

Role Description

This position is responsible for providing product support to provider data within the QNXT module. Primary tasks include:

• Adding, maintaining, and updating provider data records
• Assistance with database integrity
• Correctly configuring provider data and contract information using written guidelines

Accurate and timely provider data plays a critical role in the success of:

• Claims payment
• OHA Health Systems (DMAP) and CMS encounter data submission
• PCP assignment
• Authorization processing
• Credentialing
• IRS reporting
• Regulatory projects
• The provider directory

Estimated Hiring Range: $23.28 - $28.45

Bonus Target: Bonus - SIP Target, 5% Annual

Current CareOregon Employees: Please use the internal Workday site to submit an application for this job.

Qualifications

• Minimum 1 year of experience with data configuration, data management, credentialing, or claims management
• 2 years of experience working in health care/insurance (preferred)
• Experience with managed care and/or project participation (preferred)

Requirements

• Familiarity with relational databases
• General understanding of or ability to learn managed care and Oregon Health Plan concepts
• Familiarity with Microsoft Office Suite products, especially Excel
• Ability to learn and effectively navigate claims processing technologies, such as QNXT and Facets
• Ability to learn and effectively navigate document management and collaboration platforms, such as SharePoint and Office 365
• Ability to follow policies and procedures in performing job responsibilities
• Ability to develop skills around troubleshooting data integrity issues and root cause
• Ability to learn how to author and maintain process documentation
• Proficient communication skills, including listening, verbal, written, and customer service
• Ability to articulate instructions
• Ability to convey appropriate level of detail effectively to multiple levels of the organization including non-technical staff
• Ability to communicate status and needs
• Ability to handle multiple priorities and requests
• Demonstrates initiative and motivation
• Ability to effectively collaborate with coworkers
• Attention to details and deadlines
• Ability to see the big picture
• Developing organizational skills
• Ability to prioritize work based on direction
• Ability to develop analytical and research skills
• Ability to maintain a positive attitude
• Ability to learn governance and process
• Ability to work effectively with diverse individuals and groups
• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day
• Ability to hear and speak clearly for at least 3-6 hours/day

Benefits

• Competitive pay
• Bonus opportunity
• Comprehensive benefits package including:
• Medical, dental, vision, life, AD&D, and disability insurance
• Health savings account
• Flexible spending account(s)
• Lifestyle spending account
• Employee assistance program
• Wellness program
• Discounts and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.)
• Strong retirement plan with employer contributions
• PTO and Paid State Sick Time based on hours worked/scheduled hours
• Paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility
• 401(k) contributions for non-benefits eligible employees

Company Description

CareOregon is an equal opportunity employer. The organization selects the best individual for the job based upon job-related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.