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Provider Data Coordinator II

Charlotte, North Carolina Apply Now Job ID 1148956 Category Provider Data Management Organization Carolina Complete Health Schedule Full-time
Description:
Position Purpose: Perform day to day functions to inbound requests and maintain provider database. Audit analyses on completed requests and monitor compliance status of submitted requests.

  • Analyze inbound request to determine accuracy and route request to provider changes or other cross functional teams
  • Maintain provider data management systems for accuracy
  • Handle and resolve provider data issues, such as mass change updates, limited reconciliations and direct submissions of urgent requests
  • Coordinate provider data between the health plan database and various internal databases
  • Participate in reconciliation and provider data projects
  • Review, investigate and resolve inquiries regarding loaded providers that may have issues reported from internal and external customers
  • Submit daily and weekly internal and external status reports
  • Initiate and process provider add, change and termination forms
  • Track, update and audit provider information in database
  • Assist in Corporate audit activities or requests for claims provider set up
  • Qualifications:

    Education/Experience: High school diploma or equivalent. Associate’s degree in related field preferred. 3+ years of provider data or network administration experience, preferably in managed care. Proficient in Microsoft Access and Excel applications. Experience with data management in large databases, reporting, and analysis preferred.

    Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
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