Arbitration Specialist

Candidate is responsible for maintaining accurate and up-to-date provider information across healthcare systems and databases. This role involves processing demographic updates, credentialing-related changes, contract data maintenance, and provider network validations. The analyst ensures data quality, compliance with client and regulatory requirements, timely issue resolution, and supports operational reporting and continuous process improvement initiatives. Strong analytical skills, attention to detail, and proficiency in healthcare provider data management systems are essential for success in this role.

• Graduate in any discipline with 1-3 years of experience in US Healthcare.
• Process provider additions, terminations, demographic updates, affiliations, specialties, tax IDs, and contract changes.
• Maintain accurate provider records across healthcare systems and databases.
• Validate provider data and perform quality checks to ensure accuracy and completeness.
• Prior experience working on CertifyOS is preferred.
• Prior experience in Provider Data Management operations is preferred.
• Analyze and resolve provider data discrepancies through root cause analysis.
• Investigate and resolve provider, client, and system-related issues within SLA timelines.
• Track productivity, quality, and service-level performance metrics.
• Conduct audits and quality reviews to ensure data integrity and compliance.
• Identify process improvement opportunities and support automation initiatives.
• Ensure compliance with HIPAA, regulatory requirements, client guidelines, and organizational policies.

Graduate (non-technical)