Provider Data Services Specialist

Job Description:

  • Compare and contrast the provider system with network data and regulatory sources
  • Manage provider records for accuracy in the provider directory
  • Review and submit requests to update the provider module for adds/changes
  • Research updates to ensure compliance with CMS and AHCCCS regulations
  • Utilize standard data elements for provider data to feed member directories and regulatory reports

Requirements:

  • 1-2 years of experience in customer service
  • Must reside in Arizona
  • Strong analytical and written/oral communication skills
  • 1-2 years of experience with SQL
  • 1-2 years of experience in Microsoft Excel
  • Previous experience working with QNXT
  • Previous experience with medical claims processing
  • Previous knowledge of medical billing

Benefits:

  • medical, dental, and vision coverage
  • paid time off
  • retirement savings options
  • wellness programs
  • other resources, based on eligibility
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