Provider Data Analyst

Provider Data Analyst

At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders - internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.

Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!

JOB SUMMARY

This role maintains provider demographic data within the organizationally utilized database environment. The incumbent will regularly add and edit participating provider records in accordance with organizational and network processing guidelines.

DUTIES

1. Analyze, research, and input relevant data for providers added to the organization's network through individual contracts, facility/ancillary contracts and/or newly acquired group contracts. Maintain changes to current provider files including provider terminations. Provider records to be updated include but are not limited to: practitioner, facility, ancillary, and group records.
   2. Obtain missing data and update provider profiles specific to provider directory and/or client data extracts.
   3. Research and respond to all ad hoc requests (status checks) from both internal and external customers. Fully update provider profiles as appropriate assuring continual adherence to established operational guidelines.
   4. Identify issues that require additional investigation and evaluation, validate discrepancies incurred and ensure appropriate follow up. Refer complex issues to management for appropriate disposition.
   5. Complete special projects as assigned by management this may include but is not limited to both telephonic and electronic investigative work. Verify, research, and respond to telephone inquiries and written inquires, from providers and other departments, pertaining to provider participation in a professional and courteous manner.
   6. Partner cross-functionally as necessary to ensure accurate and efficient disposition of data investigations and maintenance work.
   7. Ensure systematic data oriented efforts to improve consumer and/or client services. One Hundred percent (100%) of this job is related to QM activities.
   8. Collaborate, coordinate, and communicate across disciplines and departments.
   9. Ensure compliance with HIPAA regulations and requirements.
   10. Demonstrate Company's Core Competencies and values held within.
   11. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

JOB SCOPE:
The incumbent works under general supervision in a self-directed and results oriented manner. The incumbent works within established standards and procedures, relying on a broad range of knowledge gained through experience to complete job responsibilities. Work involves support tasks with the majority of complex issues referred to supervisor. This job does not directly supervise other personnel.

COMPENSATION

The salary range for this position is $15 to $19 per hour. Specific offers take into account a candidate's education, experience and skills, as well as the candidate's work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.