$ 35 / hour
Amergis is seeking a Provider Data Operations Specialist facilitates all provider data upload files for the Health Plan Services health plan. Performs various analysis and interpretation to link business needs and objectives for assigned functions. Ensures provider data and provider directory is complete and accurate. Monitors, reconciles, and evaluates provider data to ensure data integrity across all Health
Plan Services Systems.
Typical Duties

• Maintains provider data though rosters and Share Point.
• Processes Medicaid and Medicare rosters from provider and facilities.
• Processes contracts via JIRA for mapping and pricing.
• Distinguishes between contract labels and rates Medicaid, Medicare, and Exchange.
• Produces and audits provider directories for multiple medical groups adding terming locations.
• Identifies discrepancies with practitioner data and information.
• Maintains medical group demographic information using Vida Pro, NPESS

Minimum Qualifications

• 3 years of recent experience in: provider data management, credentialing or healthcare operations (i.e. claims processing, billing, provider relations, or contracting) experience within a Managed Care Organization
• 1 year of recent work experience in a managed care organization network administration or operations
• High School Diploma or GED required
• Experienced with Excel, specifically formula set up to upload rosters and claims as this is a primary function of the role

Benefits

At Amergis, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits:

• Competitive pay & weekly paychecks
• Health, dental, vision, and life insurance
• 401(k) savings plan
• Awards and recognition programs

*Benefit eligibility is dependent on employment status.
About Amergis

Amergis, formerly known as Maxim Healthcare Staffing, has served our clients and communities by connecting people to the work that matters since 1988. We provide meaningful opportunities to our extensive network of healthcare and school-based professionals, ready to work in any hospital, government facility, or school. Through partnership and innovation, Amergis creates unmatched staffing experiences to deliver the best workforce solutions.
Amergis is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.