Manage the development and analysis of the quality and accuracy of provider data. Survey and report against provider data standards for database integrity to ensure the quality of provider file information in support of accurate claims payments and provider directories. Ensure adherence to internal and external standards. Act as back-up for critical provider data functions including, but not limited to, provider file extracts and the provider credentialing process.
ESSENTIAL JOB FUNCTIONS:
QUALIFICATIONS:Minimum Education and Experience:
At Blue Cross & Blue Shield of Rhode Island (BCBSRI), diversity and inclusion are central to our core values and strengthen our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity, affirmative action employer. We provide equal opportunities without regard to race, color, religion, age, national origin or ancestry, disability, veteran status, sexual orientation, genetic information, sex, gender identity or expression, and any other personal attributes protected by federal, state, or local law. For more information about our commitment to diversity and inclusion, please see our Diversity Report at bcbsri.com/diversityreport.
The law requires an employer to post notices describing the Federal laws prohibiting job discrimination based on race, color, sex, national origin, religion, age, equal pay, disability, veteran status, sexual orientation, and genetic information and gender identity or expression. Please visit http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf to view the "EEO is the Law" poster.
BCBSRI is committed to working with and providing reasonable accommodation to individuals with disabilities. If, because of a disability, you need a reasonable accommodation for any part of our application process, please contact us at (401) 459-1050 for assistance.
During the application process, please allow a minimum of five business days before you contact our office to inquire about the status of your application. If you have any questions regarding your application or during the process, please contact Human Resources by phone at (401) 459-1050 or by email at email@example.com.
Southern New England, Boston, MA, Hartford, CT, Health Data Analyst, RI Health Insurer, Healthcare, Wellness, Provider, Network, Rhode Island, RI, Insurance, Certified Professional Medical Services Management, CPMSM, Certified Provider Credentialing Specialist, CPCS, Credential, Credentials, Authorization, Certified Medical Staff Coordinator, CMSC, Enrollment, Administrative, Clerical, Data, Database
In addition to the standard benefits package you would expect, we also offer:
In our ongoing efforts to mitigate the spread of COVID-19, Blue Cross & Blue Shield of Rhode Island will conduct all interviews virtually until further notice. We will continue to review applications for open positions in a timely manner. Thank you for your patience and flexibility as we adapt to the current environment!