Provider Data Coordinator

Sante Health
  • Fresno, CA
  • Full-time
  • Instant Apply
1 day ago

Job Description

NOT A REMOTE POSITIONA new opportunity awaits an Provider Data Coordinator at Santé Health System in Fresno, CA. Supporting the Provider Credentialing department, this full-time position is directly responsible for coordinating provider demographic data and ensuring demographic changes are processed timely and accurately along with ensuring accuracy of data as well as meeting all regulatory requirements as applicable. QUALIFICATIONSHigh School diploma/GED equivalent required. Three years' experience in data analytics to include at least one year of experience in a healthcare setting preferred.Experience and working knowledge of clinic operations.Proficient user of MS Office Suite primarily Microsoft Excel.Working knowledge of managed care environment and associated lines of business such as HMO/Commercial/Medicare/Medicaid.Knowledge of database software applications is a plus.CRITICAL SUCCESS FACTORSSuccess will require well-developed competencies in these areas:Working knowledge of MD Staff platform and related systems and software technologies. Ability to exercise initiative, judgment and decision-making. Knowledge of local provider market. Ability to work independently and as a team member. Excellent time management, multi-tasking, and prioritization skills required. Ability to effectively communicate with varied professional audiences.Ability to assimilate and present information logically.Ability to read, analyze and interpret provider demographic data.ESSENTIAL DUTIES AND RESPONSIBILITIESServes as a key liaison between health plans, providers and internal staff to process, review and communicate provider demographic dataMaintains provider database and demographic data for health plan rosters/directories, ensuring that data accurately reflects provider participation on various panels.Responsible for communicating demographic changes to health plans and internal staff via template report.Generates reports, both routine and ad hoc to appropriate staff or delegated groupsAssists health plans with quarterly data validation queriesResponds to health plan inquiries related to provider demographic dataAccountable for optimal usage of the existing data systems and applications Data mining, summarizing, validation and integrity of provider demographic dataResponsible for supporting Provider Credentialing initiatives including data entry, roster audits and overall provider roster. Actively participate in health plan meetings, serving as the IPA's representativeActively participate in cross-functional projects having an impact on Provider CredentialingIn the spirit of teamwork, employees are expected to follow any other job-related instructions and to perform any other job-related duties as requested.ABOUT SANTE HEALTH SYSTEMSante Health System is a Management Services Organization that serves multiple clients. "Sante" is the French word for health. Our name symbolizes our commitment to good health, progressive care, and leadership in our community.Sante is one of the largest healthcare claims and billing management companies in Central California. The strength of Sante is the extraordinary network of physicians, health plans, and other health service providers it offers the people of our valley. Sante coordinates with physicians, health plans, hospitals, and ancillary providers to ultimately benefit the patient in a managed care environment. Sante Health System provides numerous client services such as billing, claims processing, contracting, credentialing, finance, human resources, information services, marketing/communications, physician services, practice management, provider relations, quality improvement, and utilization management.Sante is celebrating over 25 years of dedicated service to the community. We deeply understand that we would not be successful in enhancing the quality of life of our patients without our incredible team. This is why we have created a work culture that is comprised of talented, driven, dedicated, innovative, and service-driven professionals. We provide competitive pay, excellent benefits including medical, dental, vision, and life insurance, 401k retirement plan, paid time off, and opportunities for advancement. Being part of our team is like being part of a big family. Join our team and make Sante Health System your home away from home.ARE YOU READY TO JOIN OUR TEAM?If you feel that you are right for this position, apply now! We look forward to meeting you! www.santehealth.net

Numbers & Facts

LocationFresno, CA
Job TypeFull-time

Skills

  • Analysis Skillsunmatched
  • Billingunmatched
  • Claims Managementunmatched
  • Claims Processingunmatched
  • Communication Skillsunmatched
  • Community and Social Servicesunmatched
  • Contract Processingunmatched
  • Cross-Functionalunmatched
  • Customer Support/Serviceunmatched
  • Data Analysisunmatched
  • Data Entryunmatched
  • Data Miningunmatched
  • Data Qualityunmatched
  • Database Management Software/Systems (DBMS)unmatched
  • Demographicsunmatched
  • Environmental Healthunmatched
  • Establish Prioritiesunmatched
  • Financeunmatched
  • Health Maintenance Organization (HMO)unmatched
  • Health Planunmatched
  • Healthcareunmatched
  • Healthcare Providersunmatched
  • Hospitalunmatched
  • Human Resourcesunmatched
  • Leadershipunmatched
  • Managed Careunmatched
  • Marketing Communicationsunmatched
  • Medicaidunmatched
  • Medical Billingunmatched
  • Medicareunmatched
  • Microsoft Excelunmatched
  • Microsoft Officeunmatched
  • Multitaskingunmatched
  • Organizational Skillsunmatched
  • Plan Meetingsunmatched
  • Presentation/Verbal Skillsunmatched
  • Provider Credentialingunmatched
  • Provider Relationsunmatched
  • Quality Managementunmatched
  • Quality of Lifeunmatched
  • Regulatory Requirementsunmatched
  • Reporting Skillsunmatched
  • Systems Administration/Managementunmatched
  • Team Playerunmatched
  • Time Managementunmatched
  • Utilization Managementunmatched

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