
Provider Data Analyst - Hybrid in San Antonio, TX
- San Antonio, TX
- $23.41-41.83 per hour
- Permanent
- Full-time
- Responsible for various activities related to the provider network database which may include any or all of the following: database maintenance, reporting and extracting data for various reports and analyses, initiating database improvement
- Ensuring timely submission to payors
- Ensuring credentialing and enrollment status, effective dates and accuracy of data loads to include roster submissions, roster reconciliation, online directory monitoring, etc.
- Assists in resolution of claims and payor lading issues
- Develops and maintains standards for database integrity and quality assurance, coordinates corrective activities to clean database and retain users, and manages communication processes with other departments regarding database improvements
- Conducts audits and provides feedback to reduce errors and improve processes and performance
- Maintains current provider data to ensure the quality of the network
- Representing the provider network area on company IT projects, reporting and tracking provider calls and complaints, or for the support, coordination, and production of the paper directory cycles
- Uses pertinent data and facts to identify and solve a range of problems within area of expertise
- Investigates non-standard requests and problems, with some assistance from others
- Prioritizes and organizes own work to meet deadlines
- Provides explanations and information to others on topics within area of expertise
- 2+ years of experience in the health care industry
- 2+ years of credentialing experience or provider enrollment
- Customer service experience
- Proficiency with MS Excel
- Proficiency in tracking, trending, and reporting on metrics
- 2+ medical billing or claims payment data entry experience
- Demonstrated knowledge of industry terminology
- Working knowledge of payor credentialing rules and regulations
- Knowledge of payor operating procedures, regulations, billing requirements, and government reimbursement programs