Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas.
You Belong At Blue
Why Join Us?
Make a Positive Impact: Your work will directly contribute to the health and well-being of Kansans.
FamilyComes First: Total rewards package that promotes the idea of family first for all employees. Paid vacation and sick leave with paid maternity and paternity available immediately upon hire
Professional Growth Opportunities: Advance your career with ongoing training and development programs.
Dynamic Work Environment: Collaborate with a team of passionate and driven individuals in a work environment that promotes flexibility.
Trust and Stability: Work for one of the most trusted companies in Kansas with over 80 years of commitment, compassion and community.
Inclusive Work Environment: We pride ourselves on fostering a workplace where everyone is valued and respected.
Benefits & Perks
Base compensation is only one component of your competitive Total Rewards package
Incentive pay program (EPIP)
Health/Vision/Dental insurance
6 weeks paid parental leave for new mothers and fathers
Fertility/Adoption assistance
2 weeks paid caregiver leave
401(k) plan matching up to 5%
Tuition reimbursement
Health & fitness benefits, discounts and resources
Job Summary
The Provider Data Specialist is responsible for coordinating, implementing, and maintaining accurate electronic provider records that support provider payments and Blue Cross Blue Shield Association provider data requirements. This role manages provider contracting agreements and associated data, ensuring that provider payments align with contractual terms, pricing methodologies, and policy updates.
The Provider Data Specialist plays a critical role in provider data modernization initiatives and contributes analytical insight and recommendations to support data integrity, operational efficiency, and continuous process improvement.
"This position is eligible to work hybrid or onsite in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment."
What you'll do
Coordinate, implement, and maintain electronic provider records used to support accurate and timely provider payments.
Manage and maintain provider contracting agreements and related records within provider data systems.
Ensure provider payments align with contractual agreements, pricing updates, and value based arrangements.
Secure, validate, and maintain provider data used to create payment records in the Provider Entry System (PES) and downstream systems, including CSI/Provider Suites.
Perform system and data testing and validation to identify deficiencies, inconsistencies, or invalid data; provide analysis and recommendations for corrective actions or system enhancements.
Monitor, apply, and audit pricing, contract, and policy changes within provider data systems to ensure ongoing compliance.
Collaborate with Provider Network Services, Reimbursement and value based teams, Claims, and other internal stakeholders to research issues, resolve data discrepancies, and support provider updates.
Utilize Excel, DB2/QMF, SQL, and related tools to pull reports, analyze data, respond to management requests, and support operational and project needs.
Participate actively in provider data modernization initiatives, including workflow improvements, system enhancements/trainings, and data governance efforts.
Contribute insights and recommendations for process improvement, data quality, and operational efficiency.
Maintain clear, consistent communication with leadership regarding project status, milestones, risks, and outcomes.
Maintain high performance standards with a focus on accuracy, timeliness, and attention to detail.
What you need
Education and Experience
High school diploma or GED required; Bachelor's degree in healthcare administration, finance, business, or a related field preferred
Minimum of two years of experience in claims, customer service, medical practice management, provider network solutions, project management, or a related healthcare operations role required.
CPC certification preferred.
Experience with DB2/QMF/SQL preferred.
Experience with PES and code maintenance preferred.
Advanced Excel skills required.
Demonstrated stakeholder manage
Numbers & Facts
Location
Topeka, Kansas
Skills
Analysis Skillsunmatched
Certified Professional Coder (CPC)unmatched
Communication Skillsunmatched
Contract Managementunmatched
Corrective Actionunmatched
Customer Support/Serviceunmatched
Data Analysisunmatched
Data Qualityunmatched
Database Technologyunmatched
Dental Insuranceunmatched
Detail Orientedunmatched
Financeunmatched
Fitnessunmatched
Healthcareunmatched
Healthcare Administrationunmatched
Healthcare Providersunmatched
High School Diplomaunmatched
IBM DB2unmatched
Incentive Programsunmatched
Leadershipunmatched
Maintain Complianceunmatched
Operational Strategyunmatched
Operational Supportunmatched
Pricingunmatched
Problem Solving Skillsunmatched
Process Improvementunmatched
Project/Program Managementunmatched
Provider Contractingunmatched
QMFunmatched
Record Keepingunmatched
Reimbursementunmatched
SQL (Structured Query Language)unmatched
System Testunmatched
Team Playerunmatched
Time Managementunmatched
Training Programunmatched
Training/Teachingunmatched
Vision Planunmatched
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