Data Management Specialist

• 2 or more years of experience in customer service, data management, communications, or credentialing verifications required.
• 2 or more years of experience in a behavioural health or related industry. Ability to type 45-50+ words per minute. Other standard office equipment including telephone, copy machines, personal computer software and mainframe/LAN data systems.
• Prior claims experience/resolution, a plus

ESSENTIAL FUNCTIONS

• Performs review, correspondence and timely, accurate record set-up and data entry. Supports internal auditing process to ensure data accuracy and integrity.
• Researches and resolves issues and ensures systems are updated, timely, appropriately and accurately.
• Responds to requests to update or change information and ensures that all changes are made within operational guidelines and accurately support all other systems related functions.
• Researches and responds to providers and other internal staff regarding complex inquiries. Develops solutions and communicates outcomes by telephone and in writing.
• Supports the implementation of new business by ensuring providers are appropriately and accurately loaded in all applicable systems.
• Records daily activities using electronic and manual systems as directed.
• Provides consultation and information to area offices regarding the composition of the provider network or specific provider statuses. Forwards provider requests for network inclusion to the area offices for review and approval.
• Assists representatives with detailed information in order to answer provider questions and returns provider calls, as requested, to communicate resolution and/or appropriate course of action.

All your information will be kept confidential according to EEO guidelines.