Manage complex provider roster creation, submission, and record reconciliation for multiple payers, ensuring compliance, database accuracy, and quality control
Oversee resolution of moderate-scope issues by prioritizing tasks, tracking progress, escalating issues with solutions, and leading cross-functional initiatives
Serve as main contact for roster inquiries, collaborating with internal teams and external payers to provide information and communicate project updates to leadership
Provide guidance and support to new and/or internal employees on systems and processes
Proactively identify areas for operational improvement and efficiency enhancement
Other duties as assigned
Bachelor’s degree or relevant, equivalent work experience
3+ years experience with payer/provider operations processes such as credentialing, provider data maintenance, contracting, or provider claims adjudication
Proven track record of identifying, analyzing, and resolving data discrepancies and issues to ensure data accuracy
Strong attention to detail
Ability to work cross-functionally and correspond professionally with key stakeholders
Intermediate Google Sheets/ Microsoft Excel skills
Experience working with CRM/Salesforce technology
Experience with multiple payer platforms and submission systems
Experience with SQL or other query language
Lean Six Sigma Black Belt certification
Prolonged periods of sitting at a desk and working on a computer.