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:
Performing basic data configuration and data entry functions
Conducting documentation collection and verification
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
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