Senior Specialist, Provider Network Administration- REMOTE

JOB DESCRIPTION Job Summary Provides senior level support for provider network administration activities. Responsible for accurate and timely validation and maintenance of critical provider information on all claims and provider databases, and ensures adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts. Essential Job Duties Generates and prepares provider-related data and reports, and ensures provider information in applicable computer system(s) is accurate. • Provides timely, accurate generation and distribution of required reports that support continuous quality improvement of the provider database, compliance with regulatory/accreditation requirements, and provider network administration business operations. Report examples may include: GeoAccess availability reports, provider online directory (including ongoing execution, quality assurance and maintenance of supporting tables), Medicare provider directory preparation, and FQHC/RHC reports. • Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to network management (ER, network access fee, etc.); and mailing label extract generation. • Reviews/analyzes data by applying job knowledge to ensure appropriate information has been provided. • Maintains department quality standards for provider demographic data with affiliation and fee schedule attachment. • Ensures ac