Provider Data Specialist

2 weeks ago


Temple, Texas, United States Collabera Full time
Job Description

About the Position:

  • We are seeking a highly skilled professional to manage provider data within our claims processing system.
  • The successful candidate will be responsible for maintaining accurate and up-to-date provider demographic and contractual information.
  • This role will involve collaborating with various departments to ensure seamless data configuration within the system.

Responsibilities:

  • Maintain provider database using credentialing data, NPPES, and other trusted sources to ensure data integrity.
  • Enter new contracts and make modifications to existing contracts in collaboration with Network Development.
  • Collect IRS W-9 forms from providers to validate and update configured information.
  • Coordinate member re-assignment upon termination of a Primary Care Provider (PCP) in collaboration with enrollment operations.
  • Select appropriate pricing templates to apply to contracts.
  • Update provider records in response to credible allegations of fraud and IRS notices.
  • Support administrative tasks related to data entry and validation for multiple departments.
  • Review provider quality reports and update provider records to meet company standards.
  • Participate in developing new policies and procedures as needed.

Education Qualification:

- Associate's degree preferred

Collabera is a Global Digital Solutions Company providing Software Engineering Solutions for the world's most tech-forward organizations in the areas of Engineering, Cloud and Data/AI. With its roots serving the engineering needs of the world's most recognized businesses in Technology, Financial Services, Telecom and Healthcare, Collabera today operates across 60 locations in 11 countries, serves 30% of the Fortune 500, and has exceeded the industry growth rate by 3-4x for several years.



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