Our Client, a Health Insurance company, is looking for a Provider Data Specialist for their Detroit, MI/Hybrid location.

 

Responsibilities:

• The original scope for bring specialist onboard is to work on PIAI projects provider data clean up measures.


• Upon completion of projects, we are finding that these projects are turning into ongoing processes.


• For example: State of Michigan BH (SOM BH) Audit provider outreach, Provider Data Confidence Value (PDCV) audit provider outreach, return mail, facility attestation noncompliant providers, daily CAQH Directory Verification task.


• Validating provider information through auditing processes to reduce and eliminate inaccurate data for accuracy and auditing purposes.


• Increase provider accuracy on members website by eliminating outdated information.


• Perform several outreaches daily to providers across Michigan to verify certainty of demo...