Provider Data Specialist

Roles and Responsibilities

The Provider Data Specialist is responsible for entering contracted providers and facilities into databases and communicating with different Healthcare Highways Departments for accurate and efficient data field uploads.

The Provider Data Specialist will work with different departments such as Networking/Contracting, Credentialing, PDM-IT and outside areas as needed.

Key Performance Indicators (KPI’s)

1. Responsible for entering contracted providers into database within reasonable timeframes.
2. Responsible for entering contracted facilities into database within reasonable timeframes.
3. Responsible for effective communication with Networking/Contracting, Credentialing, PDM-IT and/or Outside practitioner offices regarding update clarifications within 24-48 turnaround times.
4. Meet and maintain established departmental performance metrics such as ACT/Contracts, Previous Day Totals, Open Existing ACTs, Closed ACTs, Daily Inbound New Contracts, Closed New Contracts, Inbound, etc.
5. Answer questions and handle problem resolution on provider or member issues with effective efficient turnaround times.
6. Follow up with members and providers as necessary and timeliness.

Qualifications and Education Requirements

• High school diploma required, college degree a plus.
• Minimum 4 years of experience in the healthcare industry (insurance or managed care preferred)
• Experience in medical networks and claim inquiries via phone and email
• Two or more years’ telephone customer service experience in a related field
• Two or more years’ data and/or credentialing experience in a related field
• Excellent communication skills
• Strong PC skills – Word and Excel required.
• A desire to help people
• Ability to adapt communication style based on the caller's needs
• Respond well in a stressful, dynamic environment
• Flexible, uses critical thinking skills and open to learning new ideas/skills
• Team player
• Positive attitude
• Professional Appearance

Company Information

Great Place to Work Certified

Healthcare Highways is committed to revolutionizing the way healthcare is delivered by making a positive impact on the lives of patients and providers alike. We believe in a diverse, inclusive workplace and are always looking for creative, analytical, innovative, and passionate thinkers and doers who are driven to learn as well as succeed. Choosing to work for Healthcare Highways means being part of a team that values collaboration, candor, and integrity.

HCH is a company that fosters a supportive work environment, where employees are encouraged to contribute their unique perspectives and ideas and have the opportunity to be at the forefront of groundbreaking healthcare solutions. By investing in our workforce, Healthcare Highways empowers its employees’ growth and development by offering competitive hourly/salary wages and career progression. We help support our employees’ career initiatives, both professionally and personally, while maintaining a healthy work/life balance.

A career at Healthcare Highways offers an exceptional opportunity to be part of a forward-thinking organization that is transforming healthcare. With a supportive work environment, a commitment to innovation, a focus on employee growth and culture, and a dedication to improving healthcare outcomes, Healthcare Highways is an ideal choice for individuals passionate about making a meaningful difference in the healthcare industry, leading to a tangible impact on the lives of patients and their communities.

Don’t take our word for it, check out what our employees are saying by visiting our Careers page at: https://www.healthcarehighways.com/careers