Employer Industry: Healthcare Management Services

Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Comprehensive benefits package including medical, dental, and vision plans
- Flexible Health & Welfare benefits allowing customization for employees and their dependents
- 401k retirement plan with a generous employer match
- Paid Time Off and Sick Leave available
- Collaborative work environment focused on patient care

What to Expect (Job Responsibilities):
- Maintain and update provider records within the DHMSO Provider Data Network using EZCAP
- Create new provider records and work collaboratively with Contracting and Credentialing teams
- Ensure end-to-end accuracy for claims processing in partnership with Configuration, Claims, and Enrollment teams
- Address any inquiries related to provider data management
- Ensure compliance with DHPR and CMS rules for claims submission and payment across various business lines

What is Required (Qualifications):
- Minimum of 3 years of experience managing provider data and working in EZCAP
- Proven ability to collaborate with various business functions
- Working knowledge of DHPR and CMS rules for claims submission, payment, eligibility, and appeals
- Bachelor's Degree or equivalent experience

How to Stand Out (Preferred Qualifications):
- Experience in managing provider data across Commercial, Medicare, and Medi-Cal lines of business

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