Provider Database Specialist

HealthComp
Remote, United States

Learn more

Now is the time to join us! 

 

We’re Personify Health. We’re the first and only personalized health platform company to bring health, wellbeing, and navigation solutions together. Helping businesses optimize investments in their members while empowering people to meaningfully engage with their health. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.

Who are you?

 

The purpose of the Provider Database Specialist is to research, analyze and load provider information for accurate payment of claims processing in accordance with provider contracts and PPO information received.

 

In this role you will wear many hats, but your knowledge will be essential in the following:  

  • Load provider demographic data & Contract Information for all lines of business. 
  • Create Fee schedules as required for contracts received.
  • Review CMS website for updates to contracts based on Medicare guidelines.
  • Work multiple daily reports as received and forward to IT department daily.
  • Responsible for tickets related to provider issues in the edit/exception portal and insure they are worked in 5 business days.
  • Provide management weekly reports for outstanding and unresolved tickets.
  • Perform various other duties assigned by management. 

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

What you bring to the Personify Health Team:

 

In order to represent the best of what we have to offer you come to us with a multitude of positive attributes including:

  • High School diploma or equivalent.
  • 2 years prior claims processing experience and/or provider contract experience.
  • Ability to understand and interpret current CPT, ICD10, DRG, and HCPCS coding practices in accordance with Medicare and HIPAA Guidelines.

You also take pride in offering the following Core Skills, Competencies, and Characteristics:

  • Must have strong interpersonal skills and a professional demeanor; ability to work independently on projects as well as contribute to team efforts; and superior communication and organizational skills.
  • Accurate data-entry skills.
  • Excellent time management skills.
  • Proficient with Microsoft applications (Word, Excel, Outlook) and database systems. 

No candidate will meet every single desired qualification. If your experience looks a little different from what we’ve identified and you think you can bring value to the role, we’d love to learn more about you!

 

Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.

 

We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.

 

Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to [email protected]. All of our legitimate openings can be found on the Personify Health Career Site.