Provider Data Support Specialist

• Review and interpret UB‑04 and CMS‑1500 claim forms
• Evaluate claims for accuracy, completeness, and correct billing practices
• Validate provider information (TIN, NPI, addresses/locations) against internal systems and W‑9 documentation
• Maintain and update provider data within claims and provider databases
• Support accuracy and timely payment by preventing and correcting data mismatches
• Ensure integrity of provider tax information and master data
• Process overpayment requests sent from third party vendors and post payments as needed
• Collaborate with cross‑functional teams to resolve discrepancies and support timely claim processing
• Communicate with providers and policyholders to obtain missing information and clarify claim details

• 1+ years medical claim processing experience
• Experience in a production environment
• Demonstrated ability to handle multiple assignments competently, accurately, and efficiently
• Effective communications, organizational, and interpersonal skills
• High School diploma or GED

Associate degree preferred

• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access