MCS Puerto Rico
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Providers Demographic Data Analyst
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MCS Puerto Rico Overview Provides administrative support within the unit by assisting with verifying demographic information through phone calls, emails, or written correspondence with providers to maintain accurate directory information, which is subject to audits by the Center for Medicare and Medicaid Services (CMS). Generates and updates low-complexity reports as required, following the established work plans. Essential Functions
Reviews, analyzes, categorizes, and establishes actions for updating demographic data following the established processes. For specific types of providers, coordinates referrals for individuals to ensure their demographic information is accurately updated. Generates providers' demographic data reports for the company’s lines of business from the system. Communicates frequently with providers via phone or email for demographic data collection. Drafts and coordinates communications to providers through email and/or letter, stored in a folder shared with the Mailer area. Assists in the creation of printed and online directories for corporate websites. Supports with researching and querying provider demographic data. Identifies and communicates barriers or process improvements that impact the integrity of provider demographic data. Refers to the corresponding team for the coding of demographic data in the systems received by various electronic and/or paper forms. Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices. May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document. Minimum Qualifications
Education and Experience:
Bachelor’s degree in Business Administration or related field. At least six (6) months of previous experience with similar tasks, such as providers’ operational support and contracting, preferably in the Healthcare Industry. OR Education and Experience:
Associate’s Degree or at least sixty to sixty-four (60-64) approved college credits, preferably in Business Administration or related field. At least one (1) year of experience with similar tasks, such as providers’ operational support and contracting, preferably in the Healthcare Industry. “Proven experience may be replaced by previously established requirements.” Certifications / Licenses:
N/A Other:
Intermediate knowledge of Excel is required. Must be able to prepare low-complexity reports and format tables. Previous experience in a Call Center with high volume is preferred. Languages: Spanish –
Basic (comprehensive, writing and verbal) English –
Basic (comprehensive, writing and verbal) “Somos un patrono con igualdad de oportunidad en el empleo y tomamos Acción Afirmativa para reclutar a Mujeres, Minorías, Veteranos Protegidos y Personas con Impedimento” Details
Seniority level: Entry level Employment type: Full-time Job function: Information Technology Industries: Insurance Guaynabo, Puerto Rico We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
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Providers Demographic Data Analyst
role at
MCS Puerto Rico Overview Provides administrative support within the unit by assisting with verifying demographic information through phone calls, emails, or written correspondence with providers to maintain accurate directory information, which is subject to audits by the Center for Medicare and Medicaid Services (CMS). Generates and updates low-complexity reports as required, following the established work plans. Essential Functions
Reviews, analyzes, categorizes, and establishes actions for updating demographic data following the established processes. For specific types of providers, coordinates referrals for individuals to ensure their demographic information is accurately updated. Generates providers' demographic data reports for the company’s lines of business from the system. Communicates frequently with providers via phone or email for demographic data collection. Drafts and coordinates communications to providers through email and/or letter, stored in a folder shared with the Mailer area. Assists in the creation of printed and online directories for corporate websites. Supports with researching and querying provider demographic data. Identifies and communicates barriers or process improvements that impact the integrity of provider demographic data. Refers to the corresponding team for the coding of demographic data in the systems received by various electronic and/or paper forms. Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices. May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document. Minimum Qualifications
Education and Experience:
Bachelor’s degree in Business Administration or related field. At least six (6) months of previous experience with similar tasks, such as providers’ operational support and contracting, preferably in the Healthcare Industry. OR Education and Experience:
Associate’s Degree or at least sixty to sixty-four (60-64) approved college credits, preferably in Business Administration or related field. At least one (1) year of experience with similar tasks, such as providers’ operational support and contracting, preferably in the Healthcare Industry. “Proven experience may be replaced by previously established requirements.” Certifications / Licenses:
N/A Other:
Intermediate knowledge of Excel is required. Must be able to prepare low-complexity reports and format tables. Previous experience in a Call Center with high volume is preferred. Languages: Spanish –
Basic (comprehensive, writing and verbal) English –
Basic (comprehensive, writing and verbal) “Somos un patrono con igualdad de oportunidad en el empleo y tomamos Acción Afirmativa para reclutar a Mujeres, Minorías, Veteranos Protegidos y Personas con Impedimento” Details
Seniority level: Entry level Employment type: Full-time Job function: Information Technology Industries: Insurance Guaynabo, Puerto Rico We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr