Aledade
Primary Duties
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Manage complex provider roster creation, submission, and record reconciliation for multiple payers, ensuring compliance, database accuracy, and quality control
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Oversee resolution of moderate-scope issues by prioritizing tasks, tracking progress, escalating issues with solutions, and leading cross-functional initiatives
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Serve as main contact for roster inquiries, collaborating with internal teams and external payers to provide information and communicate project updates to leadership
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Provide guidance and support to new and/or internal employees on systems and processes
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Proactively identify areas for operational improvement and efficiency enhancement
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Other duties as assigned
Minimum Qualifications
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Bachelor’s degree or relevant, equivalent work experience
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3+ years experience with payer/provider operations processes such as credentialing, provider data maintenance, contracting, or provider claims adjudication
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Proven track record of identifying, analyzing, and resolving data discrepancies and issues to ensure data accuracy
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Strong attention to detail
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Ability to work cross-functionally and correspond professionally with key stakeholders
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Intermediate Google Sheets/ Microsoft Excel skills
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Experience working with CRM/Salesforce technology
Preferred Qualifications
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Experience with multiple payer platforms and submission systems
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Experience with SQL or other query language
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Lean Six Sigma Black Belt certification
Physical Requirements
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Prolonged periods of sitting at a desk and working on a computer.
Who We Are:
What Does This Mean for You?
Originally posted on Himalayas
To apply for this job please visit himalayas.app.
Working in United States
The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic consisting of 50 states and a federal capital district, Washington, D.C. The 48 contiguous states border Canada to the north and Mexico to the south, with the semi-exclave of Alaska in the northwest and the archipelago of Hawaii in the Pacific Ocean. The United States also asserts sovereignty over five major island territories and various uninhabited islands in Oceania and the Caribbean. It is a megadiverse country, with the world's th
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