Provider Integration Data Entry Specialist

Profile insights

Here’s how the job qualifications align with your profile.

Skills

Word processing

(Required)

Microsoft Word

(Required)

Microsoft Excel

(Required)

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Do you have experience in Word processing?

Education

High school diploma or GED

Associate's degree

Do you have a High school diploma or GED?

Job details

Here’s how the job details align with your profile.

Job type

Full-time

Work setting

Remote

Full job description

The Provider Integration Data Entry Specialist enters, supports and maintains provider data from multiple sources for all lines of business in multiple data sources. This role processes inquiries from internal and external customers (Providers, Provider Entities, Third Party Administrator Groups, and Employer Groups). The Provider Integration Data Entry Specialist provides excellent service to internal and external customers through demonstrated commitment to Network Health’s Mission, Values, and business operation plans.

Check out our 2024 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.

Job Responsibilities:

Demonstrate commitment and behavior aligned with the philosophy, mission, values and vision of Network Health

Appropriately apply all organizational and regulatory principles, procedures, requirements, regulations, and policies

Ability to multi-task to ensure all provider data is loaded into any/all data sources while meeting audit and regulatory requirements

Must be able to prioritize work to ensure required daily and ongoing issues are completed within the timeframe requirements of NCQA and CMS

Research, analyze, and respond to providers’ inquiries, as well as issues raised by internal personnel, providing timely solutions to problems while also handling inquiries with responses communicated verbally or in written format. The work involves the necessity for accuracy, discretion and requires analysis and research of incomplete, conflicting or complex information

Responsible for thorough investigation of data discrepancies. This includes good communication, analyzing data, critical thinking and problem solving

Ensure accuracy of provider data in multiple systems and respond to inquiries timely/accordingly.

Efficient in the use of multiple software/systems (e.g. QNXT, Echo, QuickBase, Adobe Acrobat, Microsoft Office Word/Excel). Ability to establish a rapport and professionally work with a broad spectrum of internal and external customers, maintaining proper voice tone and language in accordance with the caller's level of understanding and to ensure positive customer perception

Ability to work as a team member, as well as working with other internal departments, independently demonstrating a high level of initiative and self-direction with limited assistance

Ensure the protection of NHP/NHI/NH_TPA/NHIC hardware, software, information and data complying with NHP/NHI/NH_TPA/NHIC security requirements and policies

Ensure the protection of the privacy and confidentiality of data

Continuously look for process improvement opportunities

Perform other duties and responsibilities as assigned

Job Requirements:

High school diploma, or equivalent

Associates degree or related experience preferred

Two or more years experience in the insurance industry

At least two years work experience working with data entry, changes, and maintenance

Knowledge of insurance principles

Knowledge of databases, word processing and spreadsheet applications (Microsoft Word and Excel)

Ability to learn software and appropriate standards related to CMS, NCQA

PC proficient; data entry skills with a high degree of accuracy

Employee is responsible for carrying out daily assignments

Candidates must reside in the state of Wisconsin for consideration

August 2025 start date

We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce.

Equal Opportunity Employer

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