Data Coordinator I

Position Description:

JOB SUMMARY: Review practitioner applications for completeness and compliance with credentialing standards. Complete data entry in the system of record of application data.

JOB ROLES AND RESPONSIBILITIES:

1. Determine the appropriate contract linkage based on application and supporting document information
2. Review practitioner system record and determine credentialing requirements. Potential credentialing scenarios include initial credentialing, state transfer, multi-state and recredentialing
3. Screen the practitioner application and ensure the practitioner meets required credentialing criteria and includes all data required for loading.
4. Accurately complete data entry of all pertinent information from application and supporting documents into the system of record.
5. Assign effective date to practitioner contracts and execute individual practitioner contracts as applicable.
6. May work independently on a variety of assigned projects
7. Follows policies and procedures as they relate to NCQA and URAQ guidelines
8. Collaborate, coordinate, and communicate across disciplines and departments.
9. Ensure compliance with HIPAA regulations and requirements.
10. Demonstrate commitment to the Company’s core values.
11. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

JOB SCOPE:
The incumbent works under general supervision in a self-directed and results oriented manner. The incumbent works within established standards and procedures, relying on a broad range of knowledge gained through experience to complete job responsibilities. Work involves support tasks with low to moderate complexity with more complex issues referred to higher levels.

Qualifications:

JOB REQUIREMENTS (Education, Experience, and Training):
• High School Diploma or GED
• 1+ years experience with database functions (maintenance and manipulation of data
• Proficient PC skills
• Excellent communication, organization and attention to detail skills
• Ability to follow through and work under deadlines
• Service oriented, flexible and ability to work under pressure
• Works well in both individual and team environments.
• Required licensures, professional certifications, and/or Board certifications as applicable

As an Equal Opportunity Employer, the Company will provide equal consideration to all employees and job candidates without regard to sex, age, race, marital status, sexual orientation, religion, national origin, citizenship status, physical or mental disability, political affiliation, service in the Armed Forces of the United States, or any other characteristic protected by federal, state, or local law.