Provider Demographics Specialist
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Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota???s leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs. UCare is growing in size, membership, products, geographic coverage, and employees. We???re an organization that???s going places. Be part of a team that cares about you, be part of UCare.
The Provider Demographic Specialist will assist with the delegated credentialing process including; communication with delegated contacts, data entry of delegate profiles, and monthly reports required by regulatory requirements. Update the credentialing database with provider demographic information received. Specific duties and responsibilities include:
- Enter, adjust and maintain provider information in the credentialing database and other databases as needed.
- Assist in development and implementation of data entry policies and procedures.
- Maintain entry of delegated profiles, InfoPath Forms and assigned Service Forms.
- Assist in running monthly regulatory reports.
- Ensure correct setup for provider directories, and contract agreements for both clinic and practitioner level data in the credentialing database.
- Maintain timely communication with internal and external customers regarding the status of requests for provider data entry and correction.
- Responsible for notification to providers on demographic set up and/or credentialing completion
Minimum two years relevant experience in health care related environment, preferably in a clinic business office, insurance or HMO environment. PC experience including spreadsheet, and word processing required, preferably Microsoft Access, Excel and Word. High school graduate or equivalent required. Certified Provider Credentialing Specialist (CPCS) or Certified Medical Staff Coordinator Certification strongly desired. Prefer experience in a clinic business office, insurance or HMO environment. Delegation of credentialing/re-credentialing and/or credentialing/re-credentialing experience required.
The knowledge, skills and abilities required to be successful in this role include:
- Excellent attention to detail.
- Excellent organizational skills and time management skills.
- Good problem solving skills.
- Excellent interpersonal communication skills, verbal and written
- Excellent telephone skills with the ability to handle difficult situations
- Excellent word processing and spreadsheet skills.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You???ll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis???just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.