Senior Provider Data Specialist

1 day ago


Chicago, Illinois, United States Solving IT Full time
Senior Provider Data Maintenance Specialist

Solving IT, a leading healthcare IT solutions provider, is seeking a highly skilled Senior Provider Data Maintenance Specialist to join our team. As a key member of our data management team, you will be responsible for ensuring the accuracy and integrity of provider data used for claims processing, membership assignment, and directory purposes.

Key Responsibilities:
  • Analyze and research provider requests for adds, deletes, and changes to their information
  • Apply business rules to complete requests and ensure data accuracy
  • Contract, credential, and maintain facility and professional provider data
  • Support the implementation of special projects and manage workflow
  • Assist in training team members on business rules and network contracting
  • Identify gaps in processes and suggest improvement strategies
Requirements:
  • Bachelor's degree plus 1 year of experience with provider network contracting and credentialing systems or 5 years of experience in the healthcare industry
  • Excellent written and verbal communication skills, including interpersonal skills
  • Experience with Microsoft Office software products, including analytical tools
  • Ability to develop training materials and act as an advisor to staff
Preferred Requirements:
  • Subject matter expert for professional provider credentialing process
  • 2 years of experience with current government-sponsored health insurance networks
  • Knowledge of healthcare delivery systems, claim costing analytics, and provider network adequacy analytics
Benefits:

Solving IT offers a comprehensive benefit package to all W2 employees and their families, including five diverse health plan options, a PPO dental plan, term life/AD&D insurance, and a 401(k) savings plan. We cover a portion of the health and dental premiums for our employees.

We are committed to supporting your career advancement and encourage applications from all backgrounds. Our team is dedicated to creating an inclusive and diverse work environment that fosters personal development and team unity.



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