Lumeris Provider Data Specialist in St. Louis, Missouri

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Position:

Provider Data Specialist

Position Summary:

The Provider Data Analyst will perform the data entry of provider demographic data into Facets.

Job Description:

Role and Responsibility:

  • Loading of provider demographic data either through manual or automated process of initial provider records into provider data management system for provider directory and claims payment purposes

  • Loading of non-participating provider demographic data from either paper or electronic claims for claims payment purposes

  • Research, review and make updates within the provider data management system per provider requests

  • Outreach to provider offices to validate demographic information meets CMS compliance regulations

  • Perform quality service checks on provider data inclusive of claims processing and provider directory information

  • Perform research and resolve provider data issues as necessary

  • Research and resolve issues of provider return mail from various departments

  • Validation and entry of provider tax information from receipt of W9

  • Uploading of provider contracts and demographic forms into company Sharepoint site

  • Validation and entry of provider electronic payment and remit status from various sources

Experience, Qualifications and Education:

  • High school diploma or general education degree (GED)

  • Minimum of two years in healthcare industry preferably in provider data management, credentialing or claims processing

  • Excellent interpersonal, oral and written communication skills

  • Ability to work with details, research and analyze documents.

  • Must be detail oriented

  • Possess strong initiative, drive, and problem solving skills.

  • Proficiency with MS Office applications including Word and Excel.

  • Ability to work independently, handle multiple assignments, establish priorities, and demonstrate high level time management skills

  • Experience with Facets, SharePoint and Knowledge Lake a plus

Lumeris is an EEO/AA employer M/F/V/D.

Location:

St. Louis, MO

Time Type:

Full time

Status:

XL - FT

Join Our Growing Team!

Lumeris serves as a long-term operating partner for organizations that are committed to the transition from volume- to value-based care and delivering extraordinary clinical and financial outcomes. Lumeris enables clients to profitably achieve greater results through proven playbooks based on collaboration, transparent data and innovative engagement methodologies. Lumeris offers comprehensive services for managing all types of populations, including launching new Medicare Advantage Health Plans, Commercial and Government Health Plan Optimization, and Multi-Payer, Multi-Population Health Services Organizations (PHSOs). Currently, Lumeris is engaged with health systems, provider alliances and payers representing tens of millions of lives moving to value-based care.

Over the past seven years, we have tripled in size to more than 800 employees and built the only solution on the market with our proven outcomes. For the past six years, Essence Healthcare, a long-standing Lumeris client, has received 4.5 Stars or higher from the Centers for Medicare and Medicaid Services (CMS). Essence Healthcare was Lumeris’ pioneer client and has been leveraging Lumeris for more than a decade to operate its Medicare Advantage plans, which serve more than 60,000 Medicare beneficiaries in various counties throughout Missouri and southern Illinois.

In 2018, Lumeris was named Best in KLAS for Value-Based Care Managed Services in the area of client-reported impact on the Triple Aim by KLAS Research. This was the third year in a row Lumeris received the award, and it has only been given for three years. As the industry’s most reliable and effective partner for developing population health management solutions, our success is driving tremendous growth in our company. Join us today in making a real difference in how healthcare is delivered!

Why Join Lumeris?

At Lumeris, you will be part of team that is focused on solving the nation’s healthcare problem, and you will be able to contribute to our purpose. Our environment is fast-paced, change-oriented and focused on growth and employee engagement. At Lumeris, we know that talent is best utilized when given the opportunity to succeed. That is why we have removed the boundaries that inhibit success and focus on fostering an environment that allows employees to utilize their talents.