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Provider Data Remote Jobs in Edison, NJ (NOW HIRING)

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Healthcare Data Engineer

New York, NY · Remote

$117K - $140K/yr

Maintain a strong knowledge of medical claims, member data, and provider data. Agile Development ... Comfort working with remote team members located in the US, India, or other geographies.

Zenlaw

Data Scientist (Remote)

New York, NY · On-site +1

This data helps to mold both our long-term strategy and our day-to-day operations. As a Data ... Due to the remote nature of this role, we are unable to provide visa sponsorship.

Centene

Vice President, Provider Engagement

New York, NY · On-site +1

$188K - $359K/yr

Collaborate with others on data that impacts provider domain to ensure that provider data is being ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

IQVIA

Senior Data Team Lead (Remote)

New York, NY · Remote

$86K - $217K/yr

Hiring multiple Senior Data Team Leads across our FSP (Functional Service Provider) and Traditional ... This is a remote/WFH position with all necessary equipment provided. What You'll Do * Lead data ...

IQVIA

Senior Data Team Lead (Remote)

New York, NY · Remote

$86K - $217K/yr

Hiring multiple Senior Data Team Leads across our FSP (Functional Service Provider) and Traditional ... This is a remote/WFH position with all necessary equipment provided. What You'll Do * Lead data ...

IQVIA

Senior Data Team Lead (Remote)

Jersey City, NJ · Remote

$86K - $217K/yr

Hiring multiple Senior Data Team Leads across our FSP (Functional Service Provider) and Traditional ... This is a remote/WFH position with all necessary equipment provided. What You'll Do * Lead data ...

IQVIA

Senior Data Team Lead (Remote)

Jersey City, NJ · Remote

$86K - $217K/yr

Hiring multiple Senior Data Team Leads across our FSP (Functional Service Provider) and Traditional ... This is a remote/WFH position with all necessary equipment provided. What You'll Do * Lead data ...

Truvani

eCommerce Data Analyst - REMOTE

Newark, NJ · Remote

As a leading provider of high-quality supplements, protein powders, and snack bars, we are ... ABOUT THE POSITION As Truvani's Junior eCommerce Data Analyst, you will leverage analytics ...

Danaher

Senior Clinical Data Manager

New York, NY · On-site +1

You will be a part of the Biostatistics and Data Management team and report to the Director of ... Additional information about this remote work arrangement will be provided by your interview team.

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Provider Data Remote information

What is the difference between Provider Data Remote vs Provider Data Specialist?

AspectProvider Data RemoteProvider Data Specialist
CredentialsTypically requires healthcare data management certifications or relevant experienceOften requires similar certifications, such as medical coding or data management credentials
Work EnvironmentRemote, often independent or team-based in healthcare organizationsPrimarily office or healthcare facility-based, but can include remote options
Industry UsageCommonly used in healthcare, insurance, and medical data management

Provider Data Remote and Provider Data Specialist roles share similar credentials and industry usage, focusing on healthcare data management. The main difference lies in the work setting, with Provider Data Remote working primarily remotely, offering flexibility, while Provider Data Specialist roles may be more office-based. Both roles are essential for maintaining accurate provider information in healthcare systems.

What does a Provider Data Remote do?

A Provider Data Remote is responsible for managing and maintaining healthcare provider information, such as credentials, contact details, and contract status, within a healthcare organization's database. This role is typically performed remotely and involves verifying data accuracy, updating records, and ensuring compliance with regulatory requirements. Provider Data Remotes collaborate with providers, insurance companies, and internal teams to resolve discrepancies and support network operations. Strong attention to detail, data management skills, and familiarity with healthcare terminology are essential for success in this position.

What are some common challenges faced by Provider Data Remote professionals, and how can they be managed?

Provider Data Remote professionals often encounter challenges such as managing large volumes of complex provider information, ensuring data accuracy, and keeping up with frequent updates from multiple sources. Working remotely can also mean collaborating with cross-functional teams in different locations, which requires strong communication and organizational skills. To manage these challenges, it's helpful to use standardized data management tools, establish clear communication protocols with team members, and stay updated on industry regulations related to provider data.

What are the key skills and qualifications needed to thrive as a Provider Data Remote specialist, and why are they important?

To thrive as a Provider Data Remote specialist, you need strong attention to detail, data entry proficiency, knowledge of healthcare terminology, and typically an associate's or bachelor's degree in a related field. Familiarity with provider data management systems, Microsoft Excel, and claims processing software is commonly required, along with experience using databases like Facets or CAQH. Excellent organizational skills, problem-solving abilities, and clear communication help you stand out in this role. These skills ensure the accuracy and integrity of provider data, supporting efficient healthcare operations and compliance.
What are popular job titles related to Provider Data Remote jobs in Edison, NJ? For Provider Data Remote jobs in Edison, NJ, the most frequently searched job titles are:
What job categories do people searching Provider Data Remote jobs in Edison, NJ look for? The top searched job categories for Provider Data Remote jobs in Edison, NJ are:
What cities near Edison, NJ are hiring for Provider Data Remote jobs? Cities near Edison, NJ with the most Provider Data Remote job openings:
Provider Data Remote jobs near you
Provider File Specialist - Remote

Provider File Specialist - Remote

EmblemHealth

New York, NY • Remote

Other

Posted 18 days ago

EmblemHealth rating

9.4

Company rating: 9.4 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

9th of 281 rated insurance

Job description

Summary of Job

Conduct vendor performance auditing and support maintenance of provider data integrity across core operational processes.  Ensure adherence to contractual requirements, regulatory expectations, and customer experience standards through routine audits and follow-up.  Contribute to analytics and continuous improvement initiatives by compiling data, tracking results, and escalating issues as needed.  Compile and share data quality and workflow findings with business partners; track follow-ups and escalate issues as needed.  

Responsibilities

  • Audit vendor performance for each core process to help ensure contractual requirements are met and results align with EmblemHealth customer experience objectives. 
  • Perform routine transactional reviews, audits, and compliance checks for vendor-supported processes; document results and escalate trends or issues to leadership. 
  • Resolve day-to-day operational issues by researching root causes, coordinating with business partners and vendors, and documenting outcomes; escalate higher-risk issues and recommend enhancements to management for prioritization and execution. 
  • Maintain audit and assessment records; document findings, variances, and supporting evidence; and escalate results to management for analysis and development of corrective actions. 
  • Complete project activities and contribute knowledge within project teams and workgroups aligned with department initiatives. 
  • Share process knowledge and best practices with peers and new team members as requested. 
  • Participate in cross-functional and vendor related projects as assigned. 
  • Perform other duties as directed, assigned, or required. 

Qualifications

  • Bachelor's degree 
  • 2 - 3+ years of relevant professional work experience including auditing and assessment activities  (Required)
  • Additional years of related experience/specialized training may be considered in lieu of degree requirements  (Required) 
  • Strong collaboration skills and the ability to communicate effectively with stakeholders  (Required) 
  • Strong auditing skills that can be applied across all types of business problems  (Required) 
  • Strong communication skills (verbal, written, presentation, interpersonal) with all types/levels of audiences  (Required) 
  • Ability to organize, prioritize, and successfully manage multiple competing tasks/projects simultaneously  (Required) 
  • Previous Provider File or equivalent experience  (Required) 
  • Proficient in MS Office - Word, Excel, Access, PowerPoint, Outlook, Teams, SharePoint, etc.  (Required)
Additional Information
  • Requisition ID: 1000003222
  • Hiring Range: $48,600-$83,160

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