Job Status:

Manually Frozen

Posted Date:

5/15/2026

Tentative Start Date:

5/15/2026

Job Type:

Contract

Position Urgency:

Normal

Job Order Number:

296465

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Job Name:

OR - Provider Technical Specialist - Remote

Requisition Id:

78112, 78114 - 100.50110

Billing Codes:

SHS Health Plan Ops - COO (1000050110-10000-50110) - F

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Job Description:

JOB SUMMARY/PURPOSE

Summary: The Provider Technical Specialist performs routine provider data entry, updates, and validation tasks. This role ensures timely and accurate maintenance of provider demographic and contractual data while supporting directory accuracy and compliance.

DEPARTMENT DESCRIPTION

Description: The Provider Data Management department, within Network Management, maintains provider data integrity across all systems, supports network accuracy for claims and directories, and collaborates with internal teams such as Provider Relations, Credentialing, and Configuration to ensure operational efficiency and compliance.

TECHNICAL JOB DUTIES

1. Enters and updates provider demographic, address, and affiliation information in internal systems.
2. Performs routine data validation checks to ensure accuracy and completeness.
3. Processes basic provider change forms and credentialing updates.
4. Supports provider directory updates and required audit cycles.
5. Routes discrepancies or complex data issues for escalation.
6. Maintains documentation and follows established SOPs.
7. Assists with compliance-driven data maintenance tasks.
8. Accepts and performs other duties as assigned.

EXPERIENCE/EDUCATION/QUALIFICATIONS

1. 1+ year of administrative, data entry, or healthcare operations experience.
2. High school diploma required; associate degree preferred.
3. Basic understanding of healthcare or managed care operations.
4. Demonstrated accuracy in data entry.
5. Ability to follow defined workflows and procedures.
6. Proficiency in front-end user tools in data management platforms. (e.g. databases, cloud data warehouses, etc.)
7. Proficiency in Microsoft SharePoint
8. Health plan experience is strongly preferred, particularly in one or more of the following areas:
9. 1. Provider Relations
   2. Referral Authorization
   3. Provider Data Maintenance
   4. Claims Processing

KNOWLEDGE/SKILLS/ABILITIES

1. Effective time management skills and ability to identify when guidance is needed to prioritize workload.
2. Data entry accuracy.
3. Organization and time management.
4. Basic managed care concepts.
5. Communication and collaboration.
6. Ability to follow SOPs.
7. Detail orientation.

 

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Specialty:

Clerical

Sub Specialty(s):

Clerical/Office Assistant/Support

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Additional Information And Terms

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