Data Integrity Advocate I

Job Description

REQUIREMENTS

High School Diploma or GED as a minimum educational requirement.

At least 2 years of experience in a call center environment, with a minimum of 6 months specializing in healthcare, medical insurance, or a related field.

Proficiency in medical terminology and/or coding practices can be substituted for experience.

Possession of any required licensures, professional certifications, or Board certifications as applicable.

Comprehensive knowledge of medical and claim terminology, coupled with a deep understanding of the healthcare/managed care industry, service types, and general business processes preferred.

Exceptional communication skills (written, verbal, and listening), along with strong organizational, problem-solving, leadership, customer service, interpersonal, follow-up, and data entry abilities.

Demonstrated reliability and dependability in all tasks undertaken.

Capacity to manage escalated situations with a customer-centric and professional approach.

Ability to maintain a clear boundary between professional responsibilities and personal sentiments, ensuring confidentiality in all relevant situations.

Proficiency in dissecting, organizing, and formatting diverse types of complex provider data for promotional purposes or reporting requirements.

Skill in customizing communication styles to educate both internal and external stakeholders effectively.

Capability to work autonomously as well as collaboratively within a team environment.

Effective prioritization and time management skills.

Proficiency in utilizing relevant software, hardware, and peripherals essential to job functions, including outbound dialers, data entry interfaces, Microsoft Excel, and other Office products.

Familiarity with standard office equipment.

RESPONSIBILITIES

• Initiate outbound calls to primarily contracted network providers, navigating intricate complexities to uphold the integrity of their demographic records and network standings.
• Navigate through a diverse array of up to twenty distinct campaign types monthly, each presenting unique data challenges and regulatory requirements in a fast-paced environment.
• Manage multiple providers and locations within a single call, meticulously processing 20-40 data points per provider and location with precision, utilizing outbound dialer systems or comprehensive Excel spreadsheets.
• Employ multiple extensive research tools in a single outbound call, to validate provider information when direct contact is unattainable.
• Document interactions and results with clarity and detail, ensuring comprehensive notes and accurate data updates are captured.
• Excel in a metric-driven environment, meeting rigorous standards for attendance, quality assurance, productivity, adherence, and data integrity.
• Adapt seamlessly to various campaign types in a workday, leveraging a robust wiki knowledge base and subject matter experts to navigate each encounter effectively.
• Ensure the accuracy of information updates across all company applications, prioritizing precision in data management.
• Foster collaboration across departments and disciplines, facilitating effective communication and coordination.
• Serve as a liaison to other departments to provide inquiry resolution and identify center operational issues.
• Collaborate, coordinate, and communicate across disciplines and departments.
• Ensure compliance with HIPAA regulations and requirements.
• Demonstrate Company’s Core Competencies and values held within.

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