Data Specialist I

Job Details

Job Location Main Office - Santa Barbara, CARemote Type Fully RemotePosition Type Full TimeJob Category Provider Services

Description

While candidates from anywhere in California are welcome to apply, there is a strong preference for those who reside on the Central Coast (Ventura, Santa Barbara, San Luis Obispo, Monterey and Santa Cruz Counties). This role may offer opportunities for remote work; however, familiarity with and proximity to our local customers is valued.

​​​​​​​Central Coast Hourly Rate -  $23.30 - $32.62

Job Summary

The Data Specialist I is responsible for learning and performing foundational tasks in support of accurate and timely provider data configuration. This entry-level position focuses on developing proficiency in core provider services processes and provides essential support for basic data entry and cleanup efforts. This role involves working with internal systems and teams to ensure accuracy in the provider database and support overall data integrity. Duties of this position include, but are not limited to:

1. Performing basic data configuration and data entry functions

2. Conducting documentation collection and verification

3. Other duties, as assigned

Duties and Responsibilities

1. Performing basic data configuration and data entry functions including but not limited to:

• Supporting compliance with all regulations of DHCS and CenCal Health regarding provider data by conducting basic research to obtain accurate provider data.

• Basic configuration of provider data based on the AT/ZX reports.

• Configuring newly contracted providers into the provider database based on data received via contracting, credentialing reports and provider rosters.

• Supporting the returned mail process and completing provider address updates.

• Participating in vendor configuration processes.

• Completing credentialing and recredentialing grids, ensuring accurate and timely configuration

• Meeting performance metrics for accuracy and timeliness.

• Assisting with simpler data cleanup projects

• Escalating issues as appropriate and documenting findings.

2. Conducts documentation collection and verification, with functions including but not limited to:

• Collecting, researching and processing provider documentation to ensure associated Tax ID’s, NPI’s, affiliations and rendering providers are configured accurately and timely into the system

• Collecting, researching and verifying provider documentation, such as W9s.

• Performing provider outreach via phone, e-mail and fax to obtain provider data updates, ensuring timely documentation, and escalating to the Provider Relations Representative, as appropriate

• Verifying accuracy and completeness of documentation before submission.

3. Other duties as assigned

Qualifications

Knowledge/Skills/Abilities

• Basic knowledge of Microsoft Office, including proficiency in multiple software applications including Microsoft Office (Word and Excel), Outlook, and File 360 (scanning system).

• Ability to learn and retain complex data procedures

• Some knowledge of the principles and practices of complex provider data configuration

• Some knowledge of the methods and techniques of data entry and data auditing

• Some knowledge of the healthcare industry and managed care concepts

• Working knowledge of the principles and practices of customer service

• Good written and verbal communication skills

• Typing and 10 key accuracies

• Strong attention to detail with the ability to recognize vital information

• Ability to retain significant information regarding provider data

• Ability to critically think, effectively problem solve and initiate resolution

• Ability to perform with a high degree of accuracy, while providing great customer service

• Must have strong organizational and multitasking skills

• Collaborative mindset

• Ability to look at assigned tasks with a positive mindset

• Ability to adjust to changing priorities by shifting between tasks

• Ability to be flexible and learn new programs and processes

• Ability to perform effectively under pressure

• Ability to be flexible and quickly adapt in an evolving environment

Education and Experience

• High school diploma or equivalent; AA Degree preferred

• One year of administrative or clerical experience, preferably in healthcare or data entry.

• Experience in Medi-Cal managed care preferred