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Title: Network Data Specialist Sr

Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.

The Network Data Specialist Sr will be responsible for accurate, timely maintenance of complex provider information and synchronization of data on all claims and provider databases including expertise on business requirements for multiple business regions.

How you will make an impact:

• Leads the department in problem identification, analysis, and resolution for multiple system provider database issues.

• Participates in system testing and analysis in support of new functionality, new system processes, and business rules changes.

• Validates the data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.

• Researches and resolves complex exceptions and error reports, determine regional/cap/business indicators for multiple business areas to assure accurate reimbursement based on provider contract and area fee schedules.

• Determines training needs and train less experienced associates and outside customers on multiple provider data base systems and business requirements.

• Audits for functional and business applications, and report accuracy standards.

Minimum Requirements

• H.S. diploma

• Minimum of 3 years Provider Database Rep experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications

• Experience in the management of provider relationships preferred.

• Network management and data analysis experience preferred.

• Detailed understanding of provider networks, healthcare IT systems, data base systems, and data entry protocols preferred.

• Ability to analyze and interpret complex data, identify issues, and provide solutions preferred.

For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.