Senior System Data Coordinator

Job Description

Job Description

Position Summary:

The Senior System Data Coordinator (SDC) is responsible for ensuring the integrity and accuracy of provider data in all applications. In addition, the Senior SDC is expected to work collaboratively with all internal and external stakeholders in an effort to meet and / or exceed all regulatory and contractual provider data quality and accuracy standards.

Essential Duties and Responsibilities:

1. Provides daily support and leadership to the Provider Data Management (PDM) team. First line of support/contact for PDM team.
2. Right hand and backup to PDM Management.
3. Responsible for maintaining the Claims-PDM Work Queue (WQ) and backup training.
4. Creates, tracks, and resolves Customer Relationship Management (CRM) tasks in EPIC PDM Pool.
5. Creates banking institutions and routing numbers in EPIC for Electronic Funds Transfer (EFT) and Encounter Resubmissions.
6. Performs monthly Epic and ProviderLenz team audits.
7. Monitors high priority CRMs for timely processing (e.g., MMA network, newly credentialed and terminated providers).

1. Identifies trends and recommend improvements to mitigate potential issues.

1. Creates strategies to manage tasks and workload for PDM team, including delegation of tasks/assignments.
2. Maintains AHCA Provider Network Verification (PNV) database daily to meet government contractual obligations. (e.g., Error Analysis, Staged Providers)

1. Supports and maintains Master Provider Data records in the Epic Tapestry System.
2. Works with third-party vendors and team to ensure Master Provider Data remains current with timely and accurate changes to avoid sanctions implemented by The Agency for Health Care Administration (AHCA).
3. Responds to operational problems and provides user support.
4. Assists with policies and procedures (P&P), standard operating procedures (SOP), and training materials.
5. Maintains accuracy of provider data in EPIC and ProviderLenz, while also maintaining productivity goals.
6. Conducts provider verifications with the Agency for Health Care Administration’s Provider Master List, NPI Registry, Florida Dept of Health, Florida Division of Corporations (Sunbiz), and Florida Facility Finder.
7. Audits records to identify errors and notify the system administrators of issues.
8. Conducts training and education for new and existing PDM staff on a consistent basis.
9. Coordination and oversight of team projects.

This job description in no way states or implies that these are the only duties performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management.

Qualifications:

• Associates degree and two years of related experience preferred, or equivalent combination of education and experience.
• Proficient in Microsoft Word, Excel, and PowerPoint.
• Epic Tapestry experience.
• Must have three years of records management experience.
• Must have two years of demonstrated knowledge and understanding of the PDM process, preferably in healthcare or managed care environment.
• Customer service experience, three or more years preferred.
• Knowledge of claims processing and billing forms UBO and CMS 1500 (preferred).
• Must have two years of healthcare provider auditing experience.

Skills and Abilities:

• Ability to delegate and track team assignments.
• Must be self-motivated, self-sufficient, and detail oriented.
• Strong organizational and communication skills are a must.
• Project management skills.
• Ability to work independently with minimal supervision.
• Advanced training skills in remote and in-person environment.
• Attention to detail to ensure accuracy of provider data.
• Ability to communicate clearly and concise in English.
• Proficient oral and written communication skills with various levels of an organization (internal and external).
• Time management skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Ability to meet deadlines.
• Ability to write routine reports and correspondence.
• Ability to maintain a good rapport and cooperative working relationship with the team, other departments, and external clients.
•  Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
• Ability to deal with problems involving several concrete variables in standardized situations.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit, use hands, reach with hands and arms, and talk or hear. The employee is frequently required to stand, walk, and sit. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee must occasionally lift and/or move up to 15 pounds.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. The environment includes work inside/outside the office, travel to other offices, as well as domestic, travel. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

We are an equal opportunity employer who recruits, employs, trains, compensates and promotes regardless of age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique. We are committed to fostering, cultivating and preserving a culture of diversity, equity and inclusion.