Provider Data and Enrollment Specialist I

The primary role of the Provider Data Enrollment Specialist I is to ensure the data integrity of provider records entered and maintained in the credentialing and/or payment systems. This position may be responsible for all aspects of ensuring accurate and timely processing of provider setup to initiate credentialing, provider record updates and edits, processing provider terminations, and researching and resolving provider setup issues in the applicable systems.

This data maintenance will support network adequacy and growth, regulatory reporting, provider directories, as well as downstream systems and processes. 

Education 

• High School diploma or equivalent is  

Certification

• No certification is required

Experience

• Previous experience in Managed Care/HealthCare strongly preferred
• Related experience or skill sets in the following areas would be preferred:
• Payment Systems, Credentialing, Medicare, Managed Care (such as Blue Cross/Blue Shield)

Position work schedule 8am-5pm.