Posted 1 month ago
Provider Maintanance Specialist
AI Summary
Maintains provider records and matches claims to ensure accurate, timely processing in a health plan administration environment.
About this role
Overview
Who We Are
Because health is personal. That's why Personify Health created the first and only personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. We serve employers, health plans, and health systems with data-driven solutions that reduce costs while actually improving health outcomes. Together, our team is on a mission to empower people to lead healthier lives.
Learn even more about the work that drives us at personifyhealth.com.
Responsibilities
Ready To Keep Provider Records Accurate So Claims Can Move Without Delays?
Why This Role Matters
Claims can't process cleanly without matched, accurate provider records behind them. This role sits at that junction — pulling claims, locating or creating provider records, and maintaining the data integrity that keeps the claims operation hitting its daily targets. Precision here prevents downstream errors that affect clients and members.
What You'll Actually Do
Match claims to provider records: Pull claims from the portal, locate the corresponding provider record using Tax ID numbers in Comment Editor, and confirm accurate matches.
Add and maintain provider records: Create new provider records when none exist, and update or inactivate existing records as needed to keep the database current.
Verify provider NPI data: Look up provider NPI numbers on the NPI Registry to confirm accuracy before matching or creating records.
Hit daily production targets: Process a minimum of 350 claims per day with accuracy and consistency.
Qualifications
What You Bring to Our Team
Education & Experience
- High school diploma or equivalent required
- Prior general office and/or data entry experience, or equivalent combination of education and experience
Technical Skills
- Accurate data entry at 40 WPM minimum
- Working knowledge of Microsoft Office Suite
Our Commitment: Personify Health is an equal opportunity employer committed to diversity, equity, inclusion, and belonging. We cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive—because diversity is core to who we are and critical to our work in health and wellbeing.
Stay Safe: Personify Health will never ask for payment or sensitive personal information like social security numbers during hiring. All official communication comes from verified company email addresses and or our secure applicant tracking system. Suspicious requests? Report them to talent@personifyhealth.com. View all legitimate openings at personifyhealth.com/careers.
Skills
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