Job Description

The Provider Integration Data Entry Specialist enters, supports, and maintains provider data from multiple sources for all lines of business. This role processes inquiries from internal and external customers (Providers, Provider Entities, Third Party Administrator Groups, and Employer Groups). This role provides excellent service to internal and external customers through demonstrated commitment to Network Health's Mission, Values, and business operation plans.

Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required). Travel to the corporate office in Menasha may be required occasionally for the position, including on the first day.

Hours: 1.0 FTE, 40 hours per week, 8am - 5pm Monday through Friday

Check out our 2024 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.

Job Responsibilities:

• Ability to multi-task to ensure all provider data is loaded into any/all data sources while meeting audit and regulatory requirements
• Must be able to prioritize work to ensure required daily and ongoing issues are completed within the timeframe requirements of NCQA and CMS
• Research, analyze, and respond to providers' inquiries, as well as issues raised by internal personnel, providing timely solutions to problems while also handling inquiries with responses communicated verbally or in written format. The work involves the necessity for accuracy, discretion and requires analysis and research of incomplete, conflicting or complex information
• Responsible for thorough investigation of data discrepancies. This includes good communication, analyzing data, critical thinking and problem solving
• Ensure accuracy of provider data in multiple systems and respond to inquiries timely/accordingly.
• Efficient in the use of multiple software/systems (e.g. QNXT, Echo, QuickBase, Adobe Acrobat, Microsoft Office Word/Excel). Ability to establish a rapport and professionally work with a broad spectrum of internal and external customers, maintaining proper voice tone and language in accordance with the caller's level of understanding and to ensure positive customer perception
• Ability to work as a team member, as well as working with other internal departments, independently demonstrating a high level of initiative and self-direction with limited assistance
• Ensure the protection of hardware, software, information and data; complying with security requirements and policies
• Ensure the protection of the privacy and confidentiality of data
• Continuously look for process improvement opportunities
• Perform other duties and responsibilities as assigned

Job Requirements:

• High school diploma, or equivalent required
• Associate degree or related experience preferred
• Two or more years experience in the insurance industry preferred
• At least two years work experience working with data entry, changes, and maintenance required

Network Health is an Equal Opportunity Employer

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Job Tags

Work experience placement, Work at office, Local area, Home office, Monday to Friday,

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