Provider Data Services Specialist

Job Summary

A company is looking for a Provider Data Services Specialist - Claim Pend (Remote).

Key Responsibilities

• Research and resolve provider-related claim pends using internal systems
• Analyze root causes of pended claims related to provider data and configurations
• Update provider records and manage inventory to meet turnaround time and compliance standards

Required Qualifications

• 1-3 years of experience in healthcare operations, claims processing, or provider data roles
• Ability to interpret state-specific Medicaid requirements
• Proficiency in navigating multiple systems and tools
• Experience managing workload independently in a production-driven environment
• High school diploma or equivalent required; associate's or bachelor's degree preferred