Provider Data Specialist (Claims + Credentialing)

Remote • Posted 3 hours ago • Updated 3 hours ago

Contract W2

Remote

Depends on Experience

Fitment

Dice Job Match Score™

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Job Details

Skills

Claims Management
Facets
Health Care
Health Insurance

Summary

We are seeking a Provider Information Specialist to support provider data management, credentialing, and claims operations. The role involves maintaining accurate provider records, resolving provider inquiries, and ensuring proper setup in healthcare systems for accurate claims processing.

Key Responsibilities:

Maintain and update provider demographic, credentialing, and contract data
Setup providers in systems and assign provider IDs
Ensure accurate claims processing and provider directory updates
Investigate and resolve provider-related claims and data issues
Communicate with providers to resolve inquiries and updates
Collaborate with internal teams (Network Ops, EDI, Provider Services)
Identify process improvements and data discrepancies

Required Qualifications:

2+ years of experience in healthcare/insurance operations
Experience in provider data, credentialing, enrollment, or claims
Strong analytical, problem-solving, and communication skills
Ability to work in a fast-paced environment

Preferred Skills:

Experience with Facets, IPD, Provider Manager, or Cactus
Prior claims processing experience
Knowledge of healthcare payer systems

Education:

High School Diploma required (Bachelor s preferred)

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: 80168598
Position Id: 8928658
Posted 3 hours ago

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