Role Description The Roster Data Management Specialist is responsible for maintaining accurate, timely, and compliant roster data across internal systems and external partners, including payers and regulatory entities. This role serves as the authoritative owner of roster data and plays a critical role in ensuring provider readiness, minimizing claim denials, and supporting operational and financial performance. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Roster Data Governance & Integrity - Maintain master roster records for providers, facilities, and affiliations - Ensure data consistency across credentialing, enrollment, EHR, and payer systems - Enforce required data standards, naming conventions, and documentation requirements - Conduct routine and ad hoc audits to identify discrepancies, duplicates, or missing data - Maintain version control and audit trails for roster submissions and updates - Roster Submissions & Payer Management - Prepare, validate, and submit roster files to payers and external entities - Monitor submission status, acknowledgments, approvals, and rejections - Resolve payer feedback related to effective dates, locations, specialties, or network status - Serve as the primary point of contact for payer roster-related inquiries and escalations - Change & Lifecycle Management - Process provider and facility adds, terminations, transfers, and demographic updates - Coordinate effective dates to align with credentialing, contracting, and enrollment milestones - Ensure roster updates are implemented timely to support go-lives and billing activities - Cross-Functional Collaboration - Partner with Credentialing, Provider Enrollment, Provider Relations, Revenue Cycle, and Compliance teams - Support claims and billing teams by researching and resolving roster-related denials - Proactively communicate roster risks that may impact revenue, provider activation, or compliance - Manage Provider Data Management Shared Inbox - Create, update and maintain department job aids - Reporting & Continuous Improvement - Track roster submission cadence, payer SLAs, and resolution timelines - Identify trends, recurring issues, and root causes of roster discrepancies - Develop reports or dashboards to support leadership visibility and decision-making - Recommend process improvements to reduce errors and improve efficiency - Complete reporting requests for internal and external requirements - Compliance & Audit Support - Ensure roster data complies with payer contracts, CMS requirements, and state regulations - Support internal and external audits by providing documentation, submission history, and reconciliations - Escalate compliance risks related to incomplete or inaccurate roster data Qualifications - 3+ years of experience in provider enrollment, credentialing, roster management, or healthcare operations - Solid understanding of payer enrollment workflows and provider lifecycle management - High attention to detail with experience managing complex datasets - Proficiency with Excel and healthcare platforms such as MD-Staff, CAQH, Availity or any other payer portals Requirements - Experience supporting multi state provider networks or high volume rosters - Familiarity with CMS, Medicaid, Medicare, and commercial payer requirements - Experience partnering with Revenue Cycle to resolve claim denials - Reporting or dashboard development experience Benefits - Comprehensive benefits package - Incentive and recognition programs - Equity stock purchase - 401k contribution (all benefits are subject to eligibility requirements) Application Deadline This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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