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Healthcare Data Specialist

New York, NY · Administrative
Healthcare Data Support Specialist – Managed Care
New York, NY (Manhattan, Financial District)
 
** This is a Full Time, Benefits Available, CONTRACT opportunity, expected to last 5 months or more! **
 
Data Specialist Job Summary: 
  • The Healthcare Data Specialist plays an integral part in the maintenance of accurate databases and reports in order to monitor network compliance with federal and state requirements.
  • Responsible for providing data entry and data management support within the health plan, as it relates to the contracted provider network and federal and state requirements.
  • Create and maintain multiple databases, including:
    • contracted provider network
    • prior authorization
    • third party liability
    • provider set ups and related corrections
  • Oversee the provider termination process including adding and changing new or existing provider records in the medical information system
  • Schedule monthly provider verifications regarding provider enrollment specifications and demographic changes
  • Update delegated provider Medicare and Medicaid documents on a monthly and ad hoc basis and ensure state compliance
  • Provide appropriate reports and statistical data to other department designees for review, follow-up and resolution
Data Specialist Background:  
 
  • Requires an education level of at least a high school diploma or GED; Associate’s degree is a plus.
  • Strong data entry skills required.
  • At least 1 year experience in a medical office, hospital or health plan call center, or other healthcare support role with heavy computer & database use.
  • 1-3 years experience in claims processing, provider, or credentialing preferred.
  • Strongly prefer 1 or more years at a Managed Care Organization (Health Plan, IPA/Medical Group, HMO, TPA/MSO, etc).
  • Requires basic to intermediary familiarity with Medical terminology (1-3 years direct experience).
  • Basic knowledge of health care delivery systems, Managed Care Organizations as well as Medicaid/Medicare and related state programs is needed.
  • Proficient in Microsoft Office applications, with demonstrable skills in Access and Excel, and the ability to learn new and complex computer system applications.
  • Previous experience with database management, data reporting, and data analysis preferred.
  • Must have a minimum of 30 wpm typing with a high level of accuracy.

#ADMIN
KAYLA ROGERS
STRATEGIC DIRECTOR, NON-CLINICAL DIVISION

CareNational
kayla@carenational.com
623.201.8732 (CALL – TEXT – FAX)
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