Data Correction / Provider Data Management Specialist

5 Openings Taguig City

Role description

Responsible for identifying, investigating, and correcting discrepancies in healthcare provider information within various applications and databases. This role is critical for maintaining data integrity, ensuring accurate claims processing, regulatory compliance, and smooth business operations. The specialist will work within defined service level agreements (SLAs) and quality standards.

Key Roles and Responsibilities

• Data Verification and Validation: Perform detailed reviews of provider data (e.g., demographics, credentials, network status, payment details) to identify errors, duplicates, or inconsistencies by cross-referencing multiple sources
• Error Correction: Accurately update and correct inaccurate or incomplete provider records in the system following standardized procedures
• Root Cause Analysis: Investigate the sources of data errors and report patterns to management, contributing to continuous process improvement efforts to prevent future errors
• Quality Assurance: Conduct quality checks after corrections to ensure all updated data is consistent and accurate across all relevant systems
• Documentation and Reporting: Maintain detailed logs of all data correction requests, actions taken, and outcomes for audit purposes. Generate reports on data quality metrics and error trends
• Compliance Adherence: Ensure all data handling and correction processes comply with relevant healthcare regulations and data privacy laws (e.g., HIPAA)
• Collaboration: Coordinate with internal teams, management, and potentially external clients or providers to resolve complex data issues

Required Skills and Qualifications

• Experience: 3+ Year experience in a BPO or data processing environment, preferably within the US healthcare/insurance industry, is highly desirable.
• Attention to Detail: Exceptional attention to detail and accuracy is paramount for identifying subtle errors.
• Analytical Skills: Strong logical thinking and problem-solving abilities to research and resolve data discrepancies.
• Technical Proficiency: Competency with MS Office, data entry applications, and familiarity with relational databases.
• Communication: Good verbal and written communication skills in English to interact with clients and team members.
• Work Ethic: Ability to work in a team environment, manage time effectively, and meet performance metrics in a fast-paced setting.
• Education: Degree
• Amenable to working nightshift and onsite

Skills

knowledge process outsourcing,ms office,bpo,data validation,healthcare regulations,hipaa,data processing,

About UST

UST is a global digital transformation solutions provider. For more than 20 years, UST has worked side by side with the world’s best companies to make a real impact through transformation. Powered by technology, inspired by people and led by purpose, UST partners with their clients from design to operation. With deep domain expertise and a future-proof philosophy, UST embeds innovation and agility into their clients’ organizations. With over 30,000 employees in 30 countries, UST builds for boundless impact—touching billions of lives in the process.