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.

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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

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