Note: The job is a remote job and is open to candidates in USA. SKYGEN USA is a company that focuses on provider data management, and they are seeking a Provider Data Management Representative I. In this role, you will manage provider directories, resolve data discrepancies, and coordinate with various teams to ensure accurate provider information.
Responsibilities
- Manage provider directories, including entering data for new records, termination of existing records, and ongoing audits and corrections for active records
- Utilize research and knowledge of network configurations and the Enterprise system to resolve provider data questions and discrepancies
- Set up newly activated provider records in the Enterprise system’s participating networks
- Manually load rejected provider data into the Enterprise system, reviewing data for discrepancies in data received
- Research or coordinate or escalate for clarification from the client for issues related to data received
- Perform quarterly data verification procedures in accordance with company procedures and CMS requirements, validating the provider network
- Coordinate with Provider Relations to conduct outreach to provider offices to resolve provider data questions and discrepancies
- Utilize the Provider-related modules in the Enterprise System to research and resolve provider data set up issues and discrepancies
- Complete follow ups, service tickets, and emails according to the department expectations
- Work with internal departments to resolve simple to moderately complex follow ups and service tickets generated from clients, providers and internal sources
- Using automated systems, maintain updated data on client and Skygen owned provider networks by verifying accuracy and handling any exceptions or issues
- Work directly with client representatives to resolve provider data issues and update provider data per client or provider request
- Act as a liaison between internal Skygen teams to resolve escalated contracting and fee issues related to provider data errors or discrepancies
- Act as a liaison between internal Skygen team and Dental Reimbursement to resolve any escalated claim inquiry related to provider data errors or discrepancies
- Work with internal departments to resolve provider complaints and escalations including state level complaints
- Assist Client Services in researching and resolving client inquiries that involve in depth knowledge of provider set ups
- Process EFT set up requests form provider offices
Skills
- High school diploma or equivalent
- 1 -2 years of prior related experience in resolving escalated and challenging customer/client issues
- Experience managing large quantities of data accurately and efficiently
- Experience identifying and resolving data discrepancies
- Intermediate knowledge of Microsoft Office products including Word, Excel, and Outlook
- Solid communication written and verbal communication skills
- Ability to communicate effectively with a variety of communication styles
- Strong analytical skills
- Ability to effectively listen and respond to internal and external customer needs
- Ability to resolve routine to moderately complex problems
- Ability to adapt to changing priorities
- Ability to successfully work cross-functionally to resolve problems
- High degree of accuracy
- Ability to recognize patterns and variation in data and identify errors
- 2 year degree or some formal education beyond high school
- 1-2 years in a data management or provider data management role
- Knowledge of standard dental, medical and/or therapy terminology
- Knowledge of internal software
- SQL Experience
Company Overview
Construction & Engineering It was founded in 2012, and is headquartered in Moscow, Moscow City, RUS, with a workforce of 1001-5000 employees. Its website is https://www.skygen.com.
Apply Now