Provider Data Representative

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $22 - $31 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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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 • Ensure provider data integrity for claims payment, credentialing compliance, directory accuracy, and network participation • Partner with Provider Relations, Credentialing, Provider Data, Claims Operations, and Contracting teams • Process provider roster submissions, updates, additions, terminations, and changes within SLAs • Validate and update NPIs, TINs, specialties, practice locations, EFT details, affiliations, and licenses • Reconcile provider rosters against credentialing, claims, enrollment, terms and conditions, and directory systems • Identify and coordinate resolution of discrepancies affecting participation, claims payment, and directory accuracy • Support credentialing, 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, QA programs, and process improvements • Collaborate with Claims Operations on discrepancies, root-cause analysis, and remediation • Produce provider data quality reports, discrepancy logs, dashboards, and audit results • Track productivity, turnaround times, accuracy metrics, and issue remediation • Provide operational insights to leadership • Communicate data requirements and discrepancies to credentialing, enrollment, and provider relations teams • Recommend system enhancements, automation opportunities, and workflow updates • Support implementation of new processes, templates, and operational tools

🎯 Requirements

• Associates Degree • 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 • No security clearance currently required • No security clearance required to obtain • MBI (T2) public trust/other requirement • Less than 10% travel • Bachelor’s degree preferred • 5+ years of relevant experience preferred • Experience supporting federal or government-sponsored healthcare programs preferred • Knowledge of provider directory regulatory requirements and healthcare data standards preferred • Experience with provider portals, enrollment systems, or enterprise provider data platforms preferred • US citizenship is not required

🏖️ Benefits

• Comprehensive benefits and wellness packages • 401K with company match • Competitive pay • Paid time off • Medical plan options, some with Health Savings Accounts • Dental plan options • Vision plan options • Full flex work weeks where possible • Vacation, sick, and personal time • Paid holidays • Paid parental leave • Military leave • Bereavement leave • Jury duty leave • 15 days of paid leave per calendar year for new employees, typically • 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 • AI-powered career tool identifying career steps and learning opportunities • Internal mobility team supporting career goals • Award-winning culture of innovation • Military-friendly workplace