Associate Provider Data Integrity Specialist
Company: Blue Cross Blue Shield of Rhode Island
Posted on: February 16, 2020
Associate Provider Data Integrity SpecialistFull Time - Job ID
999 - Posted: 02/11/2020Job DescriptionManage the development and
analysis of the quality and accuracy of provider data. Survey and
report against provider data standards for database integrity to
ensure the quality of provider file information in support of
accurate claims payments and provider directories. Ensure adherence
to internal and external standards. Act as back-up for critical
provider data functions including, but not limited to, provider
file extracts and the provider credentialing process.ESSENTIAL JOB
- Review and measure the quality of all data in the provider
databases through coordination of ongoing quality analysis,
verification, and analytical audit activities.
- Provide ongoing quality control audits and verifications to
ensure accuracy and security of data stored in databases.
- Survey and report against provider data standards for database
integrity to ensure the quality of provider file information in
support of accurate claims payments and provider directories.
Ensure adherence to internal and external standards.
- Serve as back-up to distribute provider files to support
organizational areas in accordance with established time frames and
- Serve as back-up for the provider credentialing oversight and
completion of administrative tasks associated with the
- Liaison with provider practices for roster review.
- Develop communication to providers related to provider data
- Perform other duties as assigned.QUALIFICATIONS:Minimum
Education and Experience:
- Bachelor's degree in Health Services Administration, Computer
Science, Information Technology, or related field; or an equivalent
combination of education and experience.
- One to three years of experience in a healthcare
field.Preferred Education, Additional Qualifications, and
- Knowledge of Facets claims processing systems.
- Knowledge of credentialing and provider database
- Knowledge of provider enrollment processes.Required Knowledge,
Skills, and/or Abilities:
- Proficiency with Microsoft suite of products, i.e., Word,
Excel, PowerPoint, etc.
- Strategic and critical thinking skills.
- Strong analytical skills.
- Strong written and verbal communication skills.
- Strong problem-solving skills.
- Ability to work effectively with a wide variety of people in
individual and group settings.
- Strong organizing skills with the ability to prioritize and
respond to shifting deadlines.
- Strong time management skills.
- Ability to manage diverse and deadline-oriented workflow.Apply
OnlineAt Blue Cross & Blue Shield of Rhode Island (BCBSRI),
diversity and inclusion are central to our core values and
strengthen our ability to meet the challenges of today's healthcare
industry. BCBSRI is an equal opportunity, affirmative action
employer. We provide equal opportunities without regard to race,
color, religion, age, national origin or ancestry, disability,
veteran status, sexual orientation, genetic information, sex,
gender identity or expression, and any other personal attributes
protected by federal, state, or local law. For more information
about our commitment to diversity and inclusion, please see our
Diversity Report atbcbsri.com/diversityreport.The law requires an
employer to post notices describing the Federal laws prohibiting
job discrimination based on race, color, sex, national origin,
religion, age, equal pay, disability, veteran status, sexual
orientation, and genetic information and gender identity or
view the "EEO is the Law" poster.BCBSRI is committed to working
with and providing reasonable accommodation to individuals with
disabilities. If, because of a disability, you need a reasonable
accommodation for any part of our application process, please
contact us at (401) 459-1050 for assistance.During the application
process, please allow a minimum of five business days before you
contact our office to inquire about the status of your application.
If you have any questions regarding your application or during the
process, please contact Human Resources by phone at (401) 459-1050
or by email email@example.com.Southern New England, Boston, MA,
Hartford, CT, Health Data Analyst, RI Health Insurer, Healthcare,
Wellness, Provider, Network, Rhode Island, RI, Insurance, Certified
Professional Medical Services Management, CPMSM, Certified Provider
Credentialing Specialist, CPCS, Credential, Credentials,
Authorization, Certified Medical Staff Coordinator, CMSC,
Enrollment, Administrative, Clerical, Data, Database
Keywords: Blue Cross Blue Shield of Rhode Island, Providence , Associate Provider Data Integrity Specialist, Other , Providence, Rhode Island
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