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The Network Provider Information Specialist is responsible for managing and maintaining accurate and up-to-date provider information within the healthcare network. This includes supporting the provider enrollment, credentialing, and data entry processes, as well as ensuring compliance with regulatory requirements. The specialist works closely with internal teams, such as network development, provider relations, claims, and customer service, to address provider-related inquiries and resolve issues. They contribute to the overall efficiency of the provider network. This role requires strong attention to detail, effective communication skills, and the ability to handle multiple tasks in a fast-paced environment while ensuring the accuracy and integrity of provider data.

Scope: 

In this role you as a Network Provider Information Specialist, you will play a critical role in ensuring the accuracy, integrity, and timely management of provider data. This position is responsible for maintaining comprehensive records of healthcare providers, supporting the provider credentialing and enrollment processes, and collaborating with internal teams to address provider-related inquiries. The specialist ensures that the provider network is up-to-date, compliant with regulations, and aligned with organizational goals. Additionally, they contribute to system maintenance and the resolution of issues, playing an essential part in the smooth functioning of the network management system.

The Network Provider Information Management team performs data entry of providers into Avesis systems. This includes gathering, maintaining, and managing accurate information about dental and vision providers. This team is integral to the accuracy of our provider directory and claims processing.

Avēsis is an ancillary insurance company that guides members and communities to wellness through

innovative, multidimensional, tailored offerings, delivered with a personal touch. We envision a world

where lives are lived more fully, communities are healthier, and futures are brighter for all. To be

successful at Avēsis, we perform at a high level everyday while remaining humble, helpful and positive.

Our high expectations are not for everyone. But for those of us who deeply care about the human

condition and have a passion to improve lives, this is a place to thrive.

Competencies: –

Functional:

• Data Management & Accuracy: Ability to maintain and update provider data with a high level of accuracy, ensuring data integrity.
• Healthcare Industry Knowledge: Understanding of healthcare networks, credentialing, insurance plans, and regulatory compliance requirements.
• System Proficiency: Skilled in using network management software and databases to manage and update provider information.
• Communication & Interpersonal Skills: Effective communication with internal teams.
• Problem-Solving & Critical Thinking: Ability to identify and resolve provider information issues in a timely and efficient manner.
• Attention to Detail: Ensuring accuracy by thoroughly reviewing and verifying provider data and documentation.
• Customer Service Orientation: Providing timely and professional assistance to providers and internal teams to resolve inquiries and issues.
• Time Management: Ability to manage tasks and projects effectively, ensuring deadlines and quality standards are met.
• Monitoring Incoming Notifications: Proactively monitor incoming notifications related to provider updates, changes, or compliance requirements.
• Specialty Fee Schedules: Accurately enter and update specialty fee schedules into the provider management system based on incoming data.

Core:

• Attention to Detail: Demonstrates a high level of accuracy and thoroughness in managing provider data, ensuring all records are correct and up to date.
• Organizational Skills: Ability to effectively manage multiple tasks and prioritize responsibilities to meet deadlines and maintain workflow efficiency.
• Communication Skills: Strong written and verbal communication skills to collaborate effectively with internal teams.
• Problem-Solving Abilities: Capable of identifying issues, analyzing root causes, and implementing effective solutions quickly and efficiently.
• Team Collaboration: Works effectively within cross-functional teams, contributing to the success of the organization by collaborating with va