Job Overview
- Accurately enter, update, and maintain provider information in internal systems
- Validate provider credentialing data, contracts, and demographic data to ensure accuracy
- Ensure provider records are in compliance with CMS, HIPAA, and state/federal regulations
- Conduct routine audits and reconciliations to maintain data integrity.
- Review and load the required data into the health plan system as the process guidelines require
- Manage and monitor daily activities and meet the set targets
- Work independently and complete the tasks in established timeframe with minimal supervision
- Must be able to prioritize and complete all job duty requirements
- Must be able to adhere to changes based on department and/or business
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