Provider Data Specialist
Location: Orange, California US
Job Number: 4238
Position Title: Provider Data Specialist
The Provider Data Specialist will maintain the data integrity of Alignment Healthcare’s (AHC) provider database. The Provider Data Specialist will perform data entry of all types of contracted providers, practitioners and facilities, and maintain data integrity as directed by the Provider Data Management Supervisor/Manager.
Essential duties and responsibilities includes, but are not limited to:
- Enter provider demographic information into AHC’s provider database, as well as any updates necessary to existing provider’s demographic records, including but not limited to issuing of termination date information to a provider’s demographic record.
- Assure the accuracy of the provider information in Alignment’s provider database.
- Process Change of Information (CIF) request as they come in electronically via “ProviderData” mailbox in accordance with the timeline set forth by the department’s Policy and Procedure.
- Conduct large volume system provider upload and/or termination as necessary.
- Assist Report Analyst with the production, and timely filing of all provider directories by ensuring that all directories are accurate in content. Assist in placing calls as necessary to providers to verify demographic information.
- Process assigned monthly reconciliation report related to data integrity projects.
- Monitor compliance of contracted medical groups’ adherence to AHC’s provider profile requirements and with CMS required specialty types.
- Test AHC’s provider database as necessary and assist with any system integrations related to provider database.
- General customer service both internally and externally related to provider inquiries and network status.
- Maintenance of an accurate and complete filing system, including electronic filing system (CIFs, contracts), to track demographic information loaded to AHC’s database and ensuring the security of both hard copy and scanned files.
This job has no supervisory responsibilities.
- Minimum Experience:
- 1-2 years’ experience in provider services, healthcare services or IT as clerk
- High School diploma or general education degree (GED)
- No license, certification required
- Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization.
- Reasoning Skills: Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.
- Basic computer skills required
- Proficiency in Microsoft applications a must
- Data entry minimum of 45 wpm
- Analytical and problem solving is a plus
- Medical terminology, and Healthcare coding familiarity is a plus, but not required
- Excellent organization and clerical skills
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear.
- The employee is frequently required to reach with hands and arms.
- The employee is occasionally required to stand; walk; climb or balance and stoop, kneel, crouch, or crawl.
- The employee must occasionally lift and/or move up to 10 to15 pounds.
- Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Location City: Orange
Location State: California
Community / Marketing Title: Provider Data Specialist
By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?
At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.
EEO Employer Verbiage:
Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].