Provider Data Configuration Associate

Position Type: Full Time
Location: Remote

Reports To: Business Operations Technical Support Manager

About Clever Care Health Plan

Clever Care Health Plan is a newly founded Medicare Advantage health plan serving Medicare beneficiaries in Southern California. Our employees are passionate in providing best services to our members and healthcare providers. Our three office locations are in Arcadia (Los Angeles County), Huntington Beach (Orange County) and New York City.

Job Summary

Responsible for assisting in creating and maintaining corporate approved letters using Napersoft, Word, and SQL. In addition to maintaining letters, may be responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database.

Functions and Job Responsibilities

Assists in configuration and creating letters.
Validates data prior to entry to ensure accuracy of data to be added to the system.
Maintains provider and vendor files in accordance with contracted status and demographic changes.
Generates and distributes Network Related Compliance/Regulatory and Accreditation reports.
Generate Provider Related reports to facilitate and support Provider Services, Claims, and Utilization management teams, assisting with problem research and resolution.
Assists with data preparation and maintenance of Provider Directory information.
Must be well-organized and detail orientated. Professional demeanor. Strong customer service
Performs other duties as assigned.

Education and Experience

Bachelor’s Degree or equivalent combination of education and experience, preferred

Knowledge, Skills, and Abilities

Excellent skills using Excel and Word
Comfort with SQL and database languages
Familiarity with basic statistics and data analysis
Well organized, professional demeanor, with strong customer service skills.

Physical & Working Environment

Typical Physical Demands.
Position requires a great amount of sitting and standing. Some lifting, stooping, bending, or reaching is required. May require lifting up to 15‐30 pounds. Requires manual dexterity sufficient to operate a computer, calculator and telephone. Requires normal range of hearing and vision. Requires the ability to type and file.

Typical Working Conditions.
Work is performed in an office environment and/or remotely. The job involves frequent contact with staff and public. Work may be stressful at times. May occasionally work some irregular hours.