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Provider Data Services Senior Coordinator

Work from home Full-time role Hiring

Join our dynamic team as a Provider Data Services Senior Coordinator! In this role, you'll be instrumental in ensuring the accuracy and integrity of our provider data, directly impacting our members' experience. You will oversee reviews of provider data, resolve payment issues, and collaborate with various departments to maintain high-quality data.

To succeed, you'll need strong analytical and relational skills, along with at least five years of experience in data management. You'll be a key contributor to process improvements and fostering positive working relationships. If you're passionate about data management and providing exceptional customer service, we encourage you to apply!

Key Responsibilities

  • Provide data support and data cleansing for data exchanges (essential to complex).
  • Manage complex data exchanges and maintain related documentation for projects, developments, and new product implementations.
  • Collaborate with different departments to ensure accurate provider data for our members.
  • Maintain and update provider demographic and agreement data in relevant systems, supporting claims settlement and provider directories.
  • Work with internal and external stakeholders to implement new contracts and complex agreements.
  • Identify, investigate, and lead root cause analyses (e.g., provider issues identified by PST, patterns from routine PDS reviews) and collaborate cross-functionally to suggest process improvements.
  • Directly oversee and manage reviews of provider data and escalate issues as needed.

Qualifications

  • 1-2 years of provider-related experience.
  • Proficiency in Microsoft Office Applications, including Excel.
  • Experience with Provider Data maintenance.
  • Experience in a production environment.

Preferred Qualifications

  • CPB or EPDB data knowledge.
  • Strong verbal communication skills.
  • Proven ability to manage multiple tasks.
  • Demonstrated ability to prioritize work and perform in a fast-paced environment.
  • Proven success collaborating with others to meet/exceed expectations.
  • Experience providing clear and concise written and verbal communications.
  • Demonstrated success collaborating with others to meet/exceed expectations.

Education

  • Secondary School Certificate or Comparable work experience

Compensation

The typical compensation range for this role is: $18.50 - $35.29. The actual compensation offer will depend on factors such as experience, education, location, and other relevant variables. This position is eligible for an Aetna bonus, commission, or short-term incentive program.

Benefits

Aetna offers a comprehensive benefits package including medical, dental, and vision coverage, a 401(k) retirement savings plan, a Employee Stock Purchase Plan, term life insurance, disability benefits, and various wellness programs. We also offer PTO, paid holidays, and other time off benefits.

Ready for a rewarding career? This is a great opportunity for a reliable and motivated individual. Apply now!

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