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Sr Prov Data Maintenance Spec

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Richardson, TX Albuquerque, NM Helena, MT Tulsa, OK 08/20/2024 R0034985 Compensation: $19.17 - $42.68 Exact compensation may vary based on skills, experience, and location

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

This position is responsible for the analyzing, researching, and applying business rules to complete requests received from providers regarding adds/deletes/changes to their information used for claims processing, membership assignment, and directory purposes. This position is responsible for contracting, credentialing and maintaining Facility / Professional provider data to support marketing, network contracting across all lines of business. This role involves supporting the implementation of special projects, assisting with tracking of various phases of a project and managing workflow. This position includes assisting management in familiarizing and training team members with the various business rules in network contracting and credentialing across all lines of business. In addition is responsible for identifying gaps in processes and suggesting process improvement strategies.

Required Job Qualifications:

  • Bachelor degree plus 1 year of experience with Provider Network contracting and credentialing systems OR 5 years of experience in the Health Care industry.

  • Written and verbal communication skills including interpersonal skills.

  • Skills to develop training materials and act as an advisor to staff

  • Experience and proficiency inn Microsoft Office software products including analytical tools.

  • Experience developing reports.

Preferred Experience (not required to qualify for this role):

  • Experience in Professional Provider Credentialing Process preferred but not required

  • Experience with current government sponsored health insurance networks

  • Knowledge of health care delivery systems, claim costing analytics, and provider network adequacy analytics

This position will work from the listed office 5 days a week for the first 4-6 months. After a performance review, this role will have the opportunity to work a hybrid/flex schedule.

Sponsorship will not be provided for this role.

HCSC Employment Statement:

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

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