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Prvdr Data Mgmt Coord

4 months ago

Little Rock, United States One Call Full time
Prvdr Data Mgmt Coord

We're looking for colleagues who are ready to Think Big, Go Fast, Deliver Awe, and Win Together. These core values embody our diverse and inclusive culture and help us live out our mission of "getting people the care they need when they need it." Over the last 30 years, our company has established itself as the market leader in managed care for the workers' compensation industry. We are committed to making a positive impact in the lives of the injured workers we serve, and we have fun doing it.

Salary Range: $19.04 - $28.56Hourly

This compensation range takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At One Call, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $19.04 - $28.56Hourly

Benefits Summary:
In return for your commitment to our company's mission, we offer a vast array of benefits to help support the whole you.
  • Opportunities to work from home
  • Competitive wages with opportunities to earn annual merit increases
  • Paid development hours to use for professional and community development
  • Generous paid time off, 8 company holidays, and 2 personal days per year
  • $1,000 Colleague Referral Program
  • Enterprise Recognition Program rewarding colleagues for their extraordinary work
  • Exclusive discounts on travel, activities, and merchandise via work discount program
  • Colleague Assistance Program that provides free counseling and financial services
  • Tuition Reimbursement Program including certifications
  • Quantum Health: A healthcare navigation platform to help our colleagues make the best, most cost-effective healthcare decisions
  • Medical, dental, and vision insurance
  • Pre-Tax FSA and HSA health savings accounts
  • 401(k) matching
  • Company paid life insurance
  • Company paid short term and long-term disability
  • Referral program
  • Healthcare concierge
  • The One Call Foundation which aims to help colleagues during unexpected emergencies, from car accidents to natural disasters.
JOB SUMMARY:

The Provider Data Management Coordinator is responsible for the initial, updated loading, and maintenance of network provider demographic, credentialing, and contracting information into the appropriate One Call systems within the assigned product line. You will perform technical and data analysis and support the enablement of new data pipelines to move, transform, cleanse, and populate data into downstream systems and interfaces. This position works collaboratively with Providers, Provider Network, and all areas within One Call to ensure provider data is current and accurate. Duties include identifying, researching, and resolving inconsistent data, and maintaining provider data integrity throughout the One Call Enterprise.
  • Responsible for the initial, updated loading, and maintenance of network provider demographic, credentialing and contracting information.
  • Technical and data analysis in support of continued focus on data integrity.
  • Follows standard practices and procedures in analyzing situations or data from which answers can be readily obtained.
  • Builds stable working relationships internally and with our provider and client partners.
  • Typically requires a minimum of 2 years of experience in data management.
DUTIES & RESPONSIBILITIES:

GENERAL DUTIES: 25 %
  • Provides operational support, performs data maintenance and clean-up for data transactions (basic to complex).
  • Outreach in response and follow-up with the provider or submitter on missing information to complete data entry request.
  • Responds to inquiries and issues related to requests coming directly from providers and other One Call staff. If necessary, appropriate, and timely referral of issues to Provider Network or other One Call staff.
  • Facilitates or assists with special projects and other initiatives to ensure provider data integrity through complete and accurate entries.
  • Performs validation of system enhancements, as needed.

PROVIDER DATA MANAGEMENT: 50%
  • Accurate and timely entry, pricing loads, maintenance, and updates of provider data into the One Call systems based upon established policies and protocols and Network contract requirements.
  • Deactivate/Terminate providers per One Call policy and protocol.
  • Research, review, confirm, and make updates within the One Call systems, per provider request.

CONTRIBUTE RESPONSIBLY 25%
  • Maintain accurate databases for reporting to monitor network compliance with regulatory requirements.
  • Maintain compliance with data integrity and timeliness polices and protocols.
  • Participate in the reconciliation, provider data projects, and auditing of provider data within business systems to ensure compliance.
  • Ensure compliance with policies by rejecting any request for data entry or loads that is not permitted based on these policies.

EDUCATIONAL AND EXPERIENCE REQUIREMENTS:
  • High School diploma required. Associate degree preferred.
  • 2 + years general data management, with preferred experience in a healthcare setting or in provider data management.
  • Experience with data analytics.
  • General knowledge of the U S Healthcare system and workers compensation industry preferred.
  • Proficiency with computer systems required, including web-based applications and Microsoft Office applications which include Outlook, Word, Excel, PowerPoint, PDF editing programs, and various other applications.
  • Any combination of academic education, professional training, or work experience which demonstrates the ability to perform the duties of the position will be considered.
GENERAL KNOWLEDGE, SKILLS & ABILITIES:
  • Ability to express thoughts clearly, concisely, and effectively both verbally and in writing. Excellent verbal and written communication skills as well as listening skills and reading and writing comprehension to technical and non-technical audiences of various levels within the organization (e.g., executive, management, individual contributors).
  • Excellent problem solving, time management, and work prioritization skills.
  • Self-starter with experience handling high work volume and multiple projects.
  • Ability to establish and maintain positive relationships with internal and external customers and be a team player.
  • Ability to think and use independent judgment effectively in a high-pressure environment. Comfortable with change and possesses the ability to switch tasks and priorities seamlessly. Ability to adapt behavior in response to new information or changing circumstances. Is open to change and new information, ideas, methods, or approaches. Work and collaborate effectively and adjusts to original objective or plan to allow for the best possible results.
  • Demonstrates active listening and gives full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, not interrupting at inappropriate times, understanding the implications of new information for both current and future problem-solving
  • Must be able to successfully maintain multiple projects simultaneously, manage and meet multiple deadlines, be detail-oriented, and possess strong organizational skills.
  • Ability to assume responsibility and exercise good judgment in making decisions within the scope of authority of the position.
  • Maintains compliance with One Call's established provider data management processes and procedures. Meets client expectations and department accuracy and timeliness commitments. Complies with Accreditation and Regulatory Standards in addition to compliance with State and Federal Accreditation Standards and Regulatory Requirements.
  • Ethical conduct and the ability to respect and preserve confidential information entrusted in the course of professional duties is necessary. Reveals confidential information only to appropriate parties and in accordance with any applicable law. Maintains confidentiality regarding legal matters, privacy issues, information technology, and data integrity.
  • Performs other related duties as assigned.
  • Work collaboratively and relate effectively to others by practicing, valuing, and embracing diversity of individuals, and fostering respect and equity in the workplace.

PHYSICAL/EMOTIONAL DEMANDS & WORK ENVIRONMENT:

The Physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • For roles located in office or home settings; this job is primarily sedentary and may involve repetitive motions; the employee is regularly required to sit, use hands and fingers, speak, and hear.
  • The employee is occasionally required to stand, walk, and lift objects (up to 10 lbs. weight; up to 4 ft. height).
  • Specific vision abilities required by this job include ability to see things from a close distance and ability to adjust focus.
  • The work environment utilizes florescent lighting; noise level is moderate.
  • The emotional demand of the job may cause undue stress from, but not limited to, moderate/heavy workload.
  • Ability to work long hours - over eight in a workday, and over 40 in a work week as necessary. Reasonable accommodations will be individually assessed and possibly made to enable individuals with disabilities to perform the essential functions of the position.
  • Please be advised this job description is subject to change at any time.
PandoLogic. Keywords: Medicare Concierge, Location: Little Rock, AR - 72205 , PL: 593238859