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Provider Data Representative

3 months ago

Sunrise Manor, Nevada, United States The Cigna Group Full time
The job profile for this position is Provider Data Representative, which is a Band 1 Professional Career Track Role.

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply

Our people make all the difference in our success.

Specific responsibilities include, but are not limited to:

  • Research re-credentialing issues
  • Create cases as needed
  • Support outbound call projects
  • Reporting
  • Send out fee schedules/copies of rosters/reference guides/copies of signed contracts
  • Send out applications/add locations
  • Follow-Up on deficiencies for IQA address; other deficiencies should go back to recruiter-15 days
  • ADHOC reporting: clients for PPO, list of DDS at locations
  • Basic research in Webster on voice messages
  • Speak with offices and answer direct questions while PR managers are traveling (verify address/phone number/etc.)
  • NF's: PR manager send list of incident numbers (only for records/wait time follow-up) and ask her to contact office-document in Webster after contact has been made-will make best attempt to close-PR manager may need to get involved if non responsive-initial contact 5 days
  • Contract Entry

System Knowledge/Usage:

Webster

Sharepoint

CKIT

SMARTI

Iprovider Fee/Hyperion

SIR

BOI

Force

Pricing Model

Preferred Position Requirements:

  • High School Diploma required
  • Must be able to work independently/self starter
  • Dental Office/Clinical Knowledge a plus
  • Ability to manage multiple priorities
  • Ability to work in multiple systems
  • Strong skill set required in the following areas: analytical, listening, written and oral communication skills
  • Detail oriented

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.