Provider Data Control Analyst

3 years of relevant experience

High School/GED

The Provider Data Control Analyst is responsible for receiving, analyzing, tracking and maintaining inventory related to multiple lines of business within the Provider Data Management Department. In addition, the analyst is responsible for assisting with root cause analysis, development of reports, monitoring data accuracy and other support activities related to the Provider Maintenance inventory including resolution of provider issues.Principle Accountabilities:1. Assists the manager of Provider Data Management as necessary in assessing issues/problems being encountered by Provider Network Management, Credentialing and Claims departments.2. Analysis and maintenance of inventory which includes; receiving, analyzing, tracking and maintaining multiple lines of business. 3. Analysis and monitoring of inventory levels, to include alerting management on submissions of Non-Compliant Terminations, financial holds and changes requested by Provider Network Management, Finance and Credentialing as mandated by State regulations.4. Receipt and entry of PMP/PCP and Specialist Add/Terms in accordance with business requirements and State regulations.5. Management of the Provider Maintenance Tracking database and/or EXP Service Forms within established timeframes.6. Updating of the Provider Maintenance EXP Service Form intake process, including external customer training as required. 7. Answering calls from Provider Network Management, Credentialing and Claims to resolve questions/issues.8. Serves as a resource to Network Management Account Executives for inventory status and provider set up questions/issues.9. Reporting of weekly and monthly inventory production requirements to Provider Network Management on all lines of business. 10. Tracking issue resolutions against established timelines, alerts department of upcoming due dates to ensure adherence to standards. Escalates issues that remain open more than established thresholds.

High School/GED

Required

Relevant Experience

Required

3

Years