Provider Data Maintenance Specialist Job Listing at HCSC in Albuquerque, NM (Job ID R0036652)

Description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Summary: This position is responsible for the analyzing, researching, and applying business rules to complete requests received from providers regarding adds/deletes/changes to their information used for claims processing, membership assignment, and directory purposes. Review contracting, credentialing, and maintenance of Provider Data to support Claim's payment, Marketing, Membership and Network Contracting across all lines of business. This includes providing accurate and timely administration of provider contracts, rosters and requests supporting quality initiatives to ensure data accuracy. Responsibilities including internal provider meetings and work groups, researching problems related to provider credentialing, data and network participation. Includes working as a Liaison between Network Contracting, Enterprise Credentialing, Product Development, Special Investigations Department, Legal, Marketing, Full Service Units, ITG, Government Programs, and other business partners on network activities.

Required Job Qualifications:

• 2 years of college OR two years of experience
• Written and verbal communication skills to interact with internal and external customers
• Analytical and quantitative skills
• Ability to take initiative and work independently

Preferred Job Qualifications:

• Working knowledge of Professional Provider Credentialing Process
• 1 year of experience on the Provider Data
• Experience with Microsoft Office applications including Excel, Access, and Power Point

This position does not support sponsorship

HCSC Employment Statement:

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

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