IPA Provider Data Coordinator

4 weeks ago


Fresno, California, United States Sante Health Full time
Job Description

A new opportunity awaits an IPA Provider Data Coordinator at Santé Health System in Fresno, CA. Supporting the Provider Credentialing department, this full-time position is directly responsible for coordinating provider demographic data and ensuring demographic changes are processed timely and accurately along with ensuring accuracy of data as well as meeting all regulatory requirements as applicable.

Key Responsibilities:

  • Serves as a key liaison between health plans, providers and internal staff to process, review and communicate provider demographic data
  • Maintains provider database and demographic data for health plan rosters/directories, ensuring that data accurately reflects provider participation on various panels.
  • Responsible for communicating demographic changes to health plans and internal staff via template report.
  • Generates reports, both routine and ad hoc to appropriate staff or delegated groups
  • Assists health plans with quarterly data validation queries
  • Responds to health plan inquiries related to provider demographic data
  • Accountable for optimal usage of the existing data systems and applications
  • Data mining, summarizing, validation and integrity of provider demographic data
  • Responsible for supporting Provider Credentialing initiatives including data entry, roster audits and overall provider roster.

About Santé Health System:

Santé Health System is a Management Services Organization that serves multiple clients. Our name symbolizes our commitment to good health, progressive care, and leadership in our community.

We are one of the largest healthcare claims and billing management companies in Central California. The strength of Santé is the extraordinary network of physicians, health plans, and other health service providers it offers the people of our valley. We coordinate with physicians, health plans, hospitals, and ancillary providers to ultimately benefit the patient in a managed care environment.

We provide numerous client services such as billing, claims processing, contracting, credentialing, finance, human resources, information services, marketing/communications, physician services, practice management, provider relations, quality improvement, and utilization management.

We are celebrating over 25 years of dedicated service to the community. We deeply understand that we would not be successful in enhancing the quality of life of our patients without our incredible team. This is why we have created a work culture that is comprised of talented, driven, dedicated, innovative, and service-driven professionals.



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