Centers Plan for Healthy Living

  • Provider Data Maintenance Operator

    Job Locations US-NY-Staten Island
    Posted Date 1 month ago(12/20/2018 2:28 PM)
    # of Openings
  • Overview

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    The Provider Data Maintenance Operator assists the Provider Data Maintenance Supervisor with any of the following: provider demographic updates, contract updates, fee schedule updates, auditing, running reports, etc. The Operator will typically be assigned as a lead on any special projects that may arise.


    Primary Responsibilities:

    The Provider Data Maintenance Operator is responsible for, but not limited to:

    • Creation and maintenance of all provider records within the health plan system(s).  Includes setup of demographic and specialty information, panel, line of business and fee schedules.
    • Performs data entry accurately and timely.
    • Audit current provider contracts and data to ensure they are up to date.
    • Act as SME for other departments as it relates to provider contracts and setup
    • Trouble shoot and identify root cause of problems and collaborate with other departments to resolve. Identifies and documents opportunities for provider education.
    • Participates in standing meetings as necessary, including but not limited to provider relations, contracting, network development, team building.
    • Performs other duties and special projects as assigned and directed.


    Specific Technical Skills


    • Proficiency with MS applications, including but not limited to Word, Excel and Outlook.


    Knowledge and Skills:

    • Detail oriented, excellent follow up
    • Excellent verbal and written communication skills
    • Ability to multi-task in a fast-paced environment
    • Must be service oriented, quick learner, team player
    • Appreciation of cultural diversity and sensitivity toward target population

    Work Environment

    This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, and photocopiers.



    Education and Experience


    Preferred: BA/BS degree in a financial field or equivalent healthcare experience   

    Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.


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