JOB SUMMARY:
The Provider Data Specialist is responsible for maintaining the accuracy of data in CorVel’s national provider database (NDB). This database contains provider demographic information that drives the National PPO lookup and plays a crucial role in the bill review process. This position will be a work from home position once initial in-office training in the Richmond, VA office is complete.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
- Provider Requests – Responsible for researching credentialing, NPI, specialty, licenses and certifications required prior to adding providers and contracts, as requested through the Provider Request Manager housed within MedCheck (provider add and network review requests). It is essential that the Provider Requests be processed within 24 hours for live bills.
- Responsible for notifying PPO staff via email when items need to be escalated due to being beyond the limitations of the Provider Data Specialists knowledge, skills, ability or authority.
- Responsible for adding and terminating providers to the PPO within 5 days of receiving via SharePoint and/or group mailbox
- Responsible for updating and maintaining PPO Roster, performing all necessary changes within 30 days of receiving via SharePoint.
- Responsible for updating Provider Portal within 30 days of receipt via the Provider Request manager housed within MedCheck.
- Correct historical errors, or errors made in day-to-day NPDB, in manual reports as requested by manager.
- Ensure data integrity by merging or removing duplicate records created by the PPO loading process.
- Requires regular and consistent attendance
- Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”).
- Additional projects and duties as assigned.
KNOWLEDGE & SKILLS:
- Excellent written and verbal communication skills.
- Ability to identify, analyze and solve problems.
- Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets
- Strong interpersonal, time management and organizational skills.
- Ability to work both independently and within a team environment.
EDUCATION/EXPERIENCE:
- High school diploma or equivalent
- Minimum 1 year experience in a professional office environment
About CorVel
CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publically traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
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Source: Indeed.com
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