Provider Data Representative

Responsibilities

• Process provider roster submissions and maintain accurate demographic, enrollment, and participation records
• Reconcile provider rosters against credentialing, claims, and directory systems to identify discrepancies
• Validate provider demographic information for credentialing and recredentialing processes
• Audit provider records for completeness, accuracy, and compliance with data standards
• Identify provider data issues affecting claims adjudication and collaborate with Claims Operations for remediation
• Produce data quality reports, discrepancy logs, and productivity metrics for leadership

Requirements

• Associates Degree
• 3+ years of experience in provider data, credentialing, enrollment, or health plan operations
• Strong analytical skills and proficiency in Microsoft Excel
• Exceptional attention to detail and accuracy

Preferred Qualifications

• Bachelor's degree
• 5+ years of relevant experience
• Experience supporting federal or government-sponsored healthcare programs
• Knowledge of provider directory regulatory requirements and healthcare data standards

Benefits

• Medical, dental, and vision plan options
• 401(k) plan with company match
• Paid leave including vacation, sick, and personal time
• Paid parental, military, and bereavement leave

About the Company

GDIT is a global technology and professional services company that delivers technology solutions and mission services to every major agency across the U.S. government, defense and intelligence community.