Home ┬╗ Provider Services Data Specialist – Part Time CenCal Health Santa Barbara, CA 93110

Provider Services Data Specialist – Part Time CenCal Health Santa Barbara, CA 93110

Website CenCal Health

The CenCal Health is looking for highly talented and motivated individuals for their Santa Barbara, CA 93110 offices. If you are interested in the long-term career progression then apply for Provider Services Data Specialist – Part Time in Santa Barbara, CA 93110.

Brief Details

Job: Provider Services Data Specialist – Part Time

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Company: CenCal Health
Location: Santa Barbara, CA 93110

Job Description

The Provider Services Data Specialists perform a variety of data entry, auditing and editing functions including but not limited to:

Perform research to obtain accurate provider data. Includes contacting providers directly and accessing a variety of websites and other sources.
Enter newly contracted providers into the provider database based on data received via contracting and credentialing reports
Enter new non-contracted providers into the database and edit existing provider data to facilitate accurate claims processing and the issuance of authorizations. Includes terminating provider records as needed. Requires review of various reports as well as acting on requests from internal and external customers
Liaise with other departments to resolve member billing and authorization issues
Edit provider data on referral authorizations to facilitate clean claim submittal.
Assist other departments with provider data questions
Review provider data that is automatically loaded from contracted vendors to ensure accuracy and make corrections
Manage provider group data by periodically reviewing rosters and updating the provider database
Ensure accuracy of the provider directory by reviewing data prior to publication
Collaborate with other staff and assist with various data integrity projects.
Perform periodic data entry audits; develop and report on productivity and accuracy metrics

The Provider Services Data Specialists may also perform customer service by:

Assisting providers via phone and e-mail; triage misdirected calls and e-mails
Creating and managing web accounts to enable providers to perform transactions via our website
Providing website training to providers upon request
Enrolling providers for electronic fund transfers (EFTs)
Documenting all contact with providers in a timely fashion, and communicating with Provider Services Representatives regarding provider issues when appropriate
Other duties include:

Maintain department policies and procedures pertinent to position
Provide data and prepare reports for management
Participate in work groups and committees
Assist with special projects or other duties as assigned

Experience

Required

2 years: Provide great customer services
Perform duties with a high degree of accuracy

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