Data Integrity Specialist

All Care Health Headquarters, Grants Pass, OR, US

4 days ago Requisition

Salary Range: $24.00 To $27.00 Hourly

All Care Health offers competitive wages, an excellent benefits package including affordable healthcare, 401k retirement, wellness programs, and flexible schedule options.

This position is responsible for validating provider data reflected in the provider portal, directory, DSN, network adequacy, VBP and other reporting. Assists in quality checks and reconciliation of the data across systems to ensure accuracy of reporting across the organization. Ensures the efficient and timely completion of front-end provider data intake and validation for all health care providers and facilities.

• Validates required elements for portal, directory, credentialing and EzCap configuration
• Supports DSN, VBP, and network adequacy input and reporting
• Maintains a high quality, timely and accurate credentialing in-take process for medical healthcare providers
• Owns initial intake (applications, rosters, forms, demographic changes, network adequacy)

• Quality Assurance and Reconciliation
• Maintains up-to-date knowledge of NCQA, URAC, and JACHO credentialing standards.
• Works collaboratively and coordinates with Provider Engagement, Provider Setup, Credentialing, Contracting and other departments
• Respectfully takes direction from leadership
• Ensures complete and accurate documentation before data moves to setup
• Maintains punctual, regular and predictable attendance.
• Meets all required training including those listed in Relias Learning Module System (LMS).
• Performs other duties as assigned

This position does not have any on call responsibilities.

This position does not have any supervisory responsibilities.

Ability to perform essential job duties with or without reasonable accommodation and without posing a direct threat to safety or health of employee or others. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.

Being bilingual in another language, including American Sign Language (ASL), is an invaluable skill that enhances our ability to deliver culturally responsive care. We strongly encourage you to apply if you are bilingual.

All relevant experience can be listed in your resume to perform essential duties of the position including the following: lived, volunteer, professional, or a combination of experience and education.

High school diploma or general education degree (GED).

One to two years related experience and/or training in Healthcare or Insurance industries

Certification from NAMSS in CPCS and CPMSM or actively pursuing the certification.

• Familiarity with the Healthcare industry.
• Excellent organization and time-management skills.
• Excellent computer skills, including the Microsoft Office Suite (Outlook, Word, PowerPoint, and Excel).
• Knowledge of and compliance with HIPAA regulations.
• Knowledge of operating systems, programming languages, software programs, networks and other technologies.
• Excellent at identifying and implementing improvement activities and ensuring excellence.
• Excellent at interpreting data and using it to solve problems and gain new insights.
• Excellent at locating information and synthesizing information from various sources.

• Demonstrate accountability, inspiring trust and confidence from others.
• Self-resolve most conflicts or misunderstandings with minimal need for direct supervision.
• Work with high initiative, energy and effectiveness in a fast-past environment.
• Effectively and professionally communicate with team members and customers.
• Collaborate within a multidisciplinary, diverse team to provide professional service.
• Prioritize and organize work according to competing timelines.
• Allocate your time so that you can complete tasks within established deadlines.
• Adapt to change, learn quickly, and work with ambiguity.
• Use creativity and resourcefulness to solve new problems.
• Cope and self-manage during stressful situations.
• Meet timelines for goals with high level of quality.

Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

Ability to add, subtract, multiply, and divide in all units of measure,…