[Hiring] Provider Data Analyst @Dignity Health Management Services

Role Description

As our Provider Data Analyst, you will maintain DHMSO's provider data network in QNXT. Every day you will:

• Create and update provider records.
• Work with Contracting and Credentialing on questions.
• Partner with Configuration, Claims, and Enrollment to ensure claims are paid accurately and on time.

To be successful in this role, you will bring:

• Provider data management experience.
• QNXT or similar system knowledge.
• Meticulous accuracy.

As a remote employee, we will provide you with the equipment needed to work from home, including:

• Laptop.
• Docking station.
• Dual monitors.
• Accessories.

While this position can reside anywhere in the US, working PST business hours will be expected.

• Work on provider Load template - understand all the data elements that must be completed to load the providers and work any that error out.
• Maintain and update Monthly Rosters for multiple participating groups.
• Troubleshoot provider load configuration issues based on testing results.
• Maintain the Provider Data (demographic and contractual) for all network and non-network providers.
• Ensure all provider information is accurately recorded and maintained to provide for proper reimbursement and member access (i.e., directory listings).
• Develop and maintain standards for database integrity, database alignment, and manage communication processes with other departments regarding database improvements.

Qualifications

• Bachelor's degree or equivalent experience.
• Minimum of 3 (three) years experience managing provider data and working in QNXT.
• Proven ability to work with other business functions.
• Working knowledge of DHPR and CMS rules for Claim Submission, Claim Payment, Eligibility Appeals for Commercial, MediCare and MediCal lines of business.