Provider Data Representative

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $46.3k - $62.7k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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General Dynamics Information Technology

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1954

💼 Consulting

🏥 Healthcare

📦 Logistics

Consulting • Healthcare • Logistics

General Dynamics Information Technology is a company at the forefront of technological innovation, offering a wide range of services including consulting, digital modernization, and application services. The company is heavily involved in implementing solutions related to artificial intelligence, cloud computing, cybersecurity, high-performance computing, and quantum technologies. GDIT is committed to supporting government and defense sectors, providing mission-critical services such as logistics and supply chain management, intelligence, and homeland security. The company also focuses on diverse and inclusive hiring practices and actively promotes employee well-being. Through its digital accelerator solutions and pioneering use of emerging technologies, GDIT aims to propel agencies' missions forward and address complex technological challenges.

📋 Description

• Maintain accurate provider demographic, participation, credentialing, enrollment, roster, and directory information across systems supporting the World Trade Center Health Program • Process provider roster submissions, updates, additions, terminations, and changes within service-level agreements • Validate and update NPIs, TINs, specialties, practice locations, EFT details, affiliations, and licenses • Reconcile provider rosters against credentialing, claims, enrollment, and directory systems • Identify and coordinate resolution of discrepancies affecting participation, claims payment, reimbursement, or directory accuracy • Support credentialing and recredentialing, onboarding, enrollment, and participation activation • Audit provider records for completeness, accuracy, and compliance • Monitor directory accuracy, quality scores, and claims-impacting error rates • Support data standards, quality assurance programs, process improvements, automation, workflows, templates, and operational tools • Produce provider data quality reports, discrepancy logs, dashboards, and audit results • Track productivity, turnaround times, accuracy metrics, and issue remediation • Communicate data requirements and discrepancies to credentialing, enrollment, and provider relations teams • Collaborate with Provider Relations, Credentialing, Provider Data, Claims Operations, and Contracting • Provide insights to leadership and support root-cause analysis and remediation

🎯 Requirements

• 3+ years of experience in provider data, credentialing, enrollment, or health plan operations • Strong analytical skills • Proficiency in Microsoft Excel • Exceptional attention to detail and accuracy • Experience supporting federal or government-sponsored healthcare programs • Knowledge of provider directory regulatory requirements and healthcare data standards • Experience with provider portals, enrollment systems, or enterprise provider data platforms • Bachelor's degree preferred • No US citizenship required • MBI (T2) public trust/other requirement • Less than 10% travel

🏖️ Benefits

• Medical plan options, including plans with Health Savings Accounts • Dental plan options • Vision plan • 401(k) plan with pre- and post-tax contributions and company match • Full flex work weeks where possible • Vacation, sick, personal, holiday, parental, military, bereavement, and jury duty leave • Typically 15 days of paid leave per calendar year for new employees • 10 paid holidays per year • Up to 160 hours of paid family leave in a rolling 12-month period for eligible employees • Short- and long-term disability benefits • Life insurance • Accidental death and dismemberment insurance • Personal accident insurance • Critical illness insurance • Business travel and accident insurance