Provider Data Specialist

🔥 14 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Curana Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

🤝 B2B

⚕️ Healthcare Insurance

Healthcare • B2B • Healthcare Insurance

Curana Health is a healthcare provider focused on senior primary care and on-site clinical services in skilled nursing and senior living communities. The company partners with operators, payors, and Medicare Advantage plans to implement value-based care models, offering physician-led care teams, medical director services, care coordination (including RPM and APCM), behavioral health, and palliative care. Curana emphasizes reducing hospital readmissions, falls, and polypharmacy while improving resident satisfaction through integrated, community-based care supported by technology and payor partnerships.

📋 Description

• Maintain and update provider information within Provider Data Management systems • Verify provider data from external sources, including provider applications and credentialing teams, and update systems accordingly • Coordinate with internal and external partners to obtain missing or incomplete data and ensure regulatory compliance • Monitor data quality and accuracy, identifying and correcting discrepancies • Respond to inquiries from internal and external stakeholders regarding provider data • Generate reports to track data accuracy, completeness, and timeliness • Collaborate with claims, customer service, and network management teams to resolve provider issues • Assist with audits and data verification to ensure compliance with industry standards • Provide training and support to internal teams on provider data management systems and processes • Stay current with industry standards, regulatory requirements, and best practices in provider data management

🎯 Requirements

• High school diploma or equivalent required • 3+ years in provider data management, healthcare administration, or a related field • Familiarity with healthcare provider directories, claims processing, and credentialing a plus • Proficient in data management software, Microsoft Excel, and Microsoft Office • Experience with NPPES and similar tools • Knowledge of NCQA or CMS regulations a plus • Strong attention to detail and analytical thinking • Excellent written and verbal communication • Ability to work independently and collaboratively • Strong organizational and time management skills • Problem-solving and critical thinking ability • The company is unable to provide sponsorship for a visa at this time (H1B or otherwise).