Provider Network Data Maintenance Associate

Job not on LinkedIn

🕒 3 days ago

🏰 Missouri – Remote

🏰 Missouri – Remote

💵 $35.5k - $56.9k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 20%

What it means: the chance that no one is really hiring for this job.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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PacificSource Health Plans

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1933

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

PacificSource Health Plans is a healthcare provider that offers a range of health insurance solutions, including plans for individuals, families, and employers. Their offerings include Medicare and Medicaid plans, dental coverage, and administrative services for small and large groups. Committed to member care, PacificSource emphasizes customer service and provides various resources for health management, including mental health support and wellness programs.

📋 Description

• Enter and update provider demographic, credentialing, and contract information in PacificSource systems • Process provider additions, terminations, and changes to maintain data integrity and accurate contract rows for claims payments • Audit provider data for accuracy, compliance, regulatory requirements, and data integrity • Assist in managing current and accurate provider directories • Verify licensure, Medicare, and Medicaid eligibility using compliance-approved tools • Monitor and maintain provider records for organizational policies, procedures, and contracting regulations • Collaborate with Provider Relations, Credentialing, Contracting, and internal teams to resolve provider data issues • Research and respond to detailed provider inquiries routed from customer/provider service departments • Communicate with providers to obtain documentation or clarify data discrepancies • Support team members and overall provider network operations • Identify process improvements and contribute to quality assurance initiatives • Assist with best practices for provider data entry and maintenance • Participate in provider network expansion, system upgrade, and regulatory change projects • Maintain positive working relationships with team members and departments • Meet department and company performance, attendance, accuracy, and productivity expectations • Follow PacificSource privacy policy and HIPAA confidentiality and security requirements • Perform other duties as assigned

🎯 Requirements

• A minimum of 2 years of experience in an office environment is required • High School Diploma or equivalent required • Associate’s or Bachelor’s degree preferred • Fast and accurate data entry skills • Ability to learn and be trained on new systems, databases, and applications • Effective written and oral communication • Proficient computer skills, typing, and 10-key required • Medical terminology, CPT/ICD-10 coding preferred • Ability to work inside in a general office setting with ergonomically configured equipment • Ability to read and comprehend both written and spoken English • Ability to communicate clearly and effectively • Ability to stoop and bend, sit and/or stand for extended periods, perform repetitive typing, sorting and filing, and light lifting and carrying

🏖️ Benefits

• Equal opportunity employment • Travel may be required 5% of the time for training and/or external meetings

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