{"schemaVersion":"jobsearcher.job.v1","id":"034d61a63a79cd6eadd6d97f","url":"https://jobsearcher.com/jobs/034d61a63a79cd6eadd6d97f","canonicalUrl":"https://jobsearcher.com/jobs/034d61a63a79cd6eadd6d97f","title":"Provider Data Representative","description":"Clearance Level\nNone\nCategory\nAncillary Health\nLocation\nFalls Church, Virginia\nKey Skills For Success\nData Integrity\nData Quality\nDocument Revision\nOperations Processes\nREQ#: RQ226055\nPublic Trust: MBI (T2)\nRequisition Type: Regular\nYour Impact\nOwn your opportunity to be on the frontlines of health innovation. Deliver for America’s health agency missions and enhance lives for hundreds of millions every day.\nJob Description\nThe Provider Data Representative maintains accurate provider demographic, participation, credentialing, enrollment, roster, and directory information across all systems supporting the World Trade Center Health Program (WTCHP).\nThe role ensures provider data integrity to support accurate claims payment, credentialing compliance, provider directory accuracy, and network participation. The Representative partners with Provider Relations, Credentialing, Provider Data, Claims Operations, and Contracting to keep provider information complete, accurate, timely, and compliant with organizational standards.\nKey Outcomes & Success Metrics\nDirectory accuracy & completeness: Meet internal standards and regulatory expectations; reduce member/provider complaints due to directory errors.\nMaintenance timeliness: Process updates, additions, terminations, and changes within SLAs; reduce cycle time and backlog.\nData integrity: Improve audit scores; lower claims‑impacting data error rates; maintain accurate NPIs, TINs, specialties, practice locations, affiliations, licenses, and EFT details.\nRoster reconciliation effectiveness: Validate rosters against credentialing, enrollment, terms & conditions, claims, and directory data; correct discrepancies promptly.\nCredentialing & enrollment support: Ensure data readiness for onboarding and recredentialing; reduce participation activation delays.\nOperational reporting: Provide clear dashboards and logs for productivity, turnaround times, accuracy, and issue remediation.\nEssential Duties & Responsibilities\nData Intake & Maintenance Operations\nProcess provider roster submissions and updates.\nMaintain accurate provider demographic, enrollment, and participation records.\nValidate and update NPIs, TINs, specialties, practice locations, EFT details, and affiliations.\nEnsure timely changes supporting accurate claims payment and directory publication.\nRoster Reconciliation\nReconcile provider rosters against credentialing, claims, enrollment, and directory systems.\nIdentify discrepancies impacting participation, claims payment, or directory accuracy.\nCoordinate corrections with Provider Relations, Credentialing, and Provider Data teams.\nCredentialing & Enrollment Support\nValidate provider demographic information for credentialing/recredentialing.\nIdentify and resolve enrollment and participation discrepancies.\nEnsure data requirements are complete for onboarding and participation activation.\nData Quality & Governance\nAudit provider records for completeness, accuracy, and compliance.\nMonitor directory accuracy, quality scores, and claims‑impacting error rates.\nSupport development of data standards, QA programs, and process improvements.\nClaims & Operational Support\nIdentify provider data issues affecting claims adjudication, reimbursement, and participation.\nCollaborate with Claims Operations to resolve data discrepancies; support root‑cause analysis and remediation.\nReporting & Analytics\nProduce provider data quality reports, discrepancy logs, and audit results.\nTrack maintenance productivity, turnaround times, and accuracy metrics.\nProvide insights to leadership to guide operational improvements.\nProvider & Stakeholder Communication\nCommunicate data requirements and discrepancies to credentialing, enrollment, and provider relations teams.\nProvide clear documentation for provider updates and requests.\nProcess Improvement & Tooling\nRecommend system enhancements, automation opportunities, and updated workflows.\nSupport implementation of new processes, templates, and operational tools.\nWork Requirements\nYears of Experience\n3 + years of related experience\nmay vary based on technical training, certification(s), or degree\nCertification\nTravel Required\nLess than 10%\nSalary and Benefit Information\nThe likely salary range for this position is $46,325 - $62,675. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.\nOur Identity Verification Process\nAs part of the hiring process, we will ask you to complete an identity verification process that leverages advanced biometrics and artificial intelligence to ensure authenticity and protect against identity fraud. You are expected to be on camera during virtual interviews. We reserve the right to take your picture to verify your identity and prevent fraud. By proceeding, you authorize the collection, processing, and use of your biometric data for identity verification and security purposes.\nAbout Our Work\nWe are GDIT. 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. Our 26,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50+ countries worldwide, offering leading mission-ready capabilities in AI, cloud, cyber and software development.\nJoin our Talent Community to stay up to date on our career opportunities and events at gdit.com/tc.\nEqual Opportunity Employer / Individuals with Disabilities / Protected Veterans","company":"General Dynamics Information Technology","rawCompany":"generaldynamicsinformationtechnology","city":"Falls Church","state":"VA","isRemote":false,"isActive":false,"createdAt":"2026-08-12T13:51:39.829Z","occupations":[{"code":"29-9021.00","title":"Health Information Technologists and Medical Registrars","slug":"health-information-technologists-and-medical-registrars"},{"code":"15-2051.02","title":"Clinical Data Managers","slug":"clinical-data-managers"},{"code":"15-1243.01","title":"Data Warehousing Specialists","slug":"data-warehousing-specialists"}],"industries":[{"code":"524292","title":"Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds","slug":"pharmacy-benefit-management-and-other-third-party-administration-of-insurance-and-pension-funds"},{"code":"921190","title":"Other General Government Support","slug":"other-general-government-support"},{"code":"518210","title":"Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services","slug":"computing-infrastructure-providers-data-processing-web-hosting-and-related-services"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Provider Data Representative","description":"Clearance Level\nNone\nCategory\nAncillary Health\nLocation\nFalls Church, Virginia\nKey Skills For Success\nData Integrity\nData Quality\nDocument Revision\nOperations Processes\nREQ#: RQ226055\nPublic Trust: MBI (T2)\nRequisition Type: Regular\nYour Impact\nOwn your opportunity to be on the frontlines of health innovation. Deliver for America’s health agency missions and enhance lives for hundreds of millions every day.\nJob Description\nThe Provider Data Representative maintains accurate provider demographic, participation, credentialing, enrollment, roster, and directory information across all systems supporting the World Trade Center Health Program (WTCHP).\nThe role ensures provider data integrity to support accurate claims payment, credentialing compliance, provider directory accuracy, and network participation. The Representative partners with Provider Relations, Credentialing, Provider Data, Claims Operations, and Contracting to keep provider information complete, accurate, timely, and compliant with organizational standards.\nKey Outcomes & Success Metrics\nDirectory accuracy & completeness: Meet internal standards and regulatory expectations; reduce member/provider complaints due to directory errors.\nMaintenance timeliness: Process updates, additions, terminations, and changes within SLAs; reduce cycle time and backlog.\nData integrity: Improve audit scores; lower claims‑impacting data error rates; maintain accurate NPIs, TINs, specialties, practice locations, affiliations, licenses, and EFT details.\nRoster reconciliation effectiveness: Validate rosters against credentialing, enrollment, terms & conditions, claims, and directory data; correct discrepancies promptly.\nCredentialing & enrollment support: Ensure data readiness for onboarding and recredentialing; reduce participation activation delays.\nOperational reporting: Provide clear dashboards and logs for productivity, turnaround times, accuracy, and issue remediation.\nEssential Duties & Responsibilities\nData Intake & Maintenance Operations\nProcess provider roster submissions and updates.\nMaintain accurate provider demographic, enrollment, and participation records.\nValidate and update NPIs, TINs, specialties, practice locations, EFT details, and affiliations.\nEnsure timely changes supporting accurate claims payment and directory publication.\nRoster Reconciliation\nReconcile provider rosters against credentialing, claims, enrollment, and directory systems.\nIdentify discrepancies impacting participation, claims payment, or directory accuracy.\nCoordinate corrections with Provider Relations, Credentialing, and Provider Data teams.\nCredentialing & Enrollment Support\nValidate provider demographic information for credentialing/recredentialing.\nIdentify and resolve enrollment and participation discrepancies.\nEnsure data requirements are complete for onboarding and participation activation.\nData Quality & Governance\nAudit provider records for completeness, accuracy, and compliance.\nMonitor directory accuracy, quality scores, and claims‑impacting error rates.\nSupport development of data standards, QA programs, and process improvements.\nClaims & Operational Support\nIdentify provider data issues affecting claims adjudication, reimbursement, and participation.\nCollaborate with Claims Operations to resolve data discrepancies; support root‑cause analysis and remediation.\nReporting & Analytics\nProduce provider data quality reports, discrepancy logs, and audit results.\nTrack maintenance productivity, turnaround times, and accuracy metrics.\nProvide insights to leadership to guide operational improvements.\nProvider & Stakeholder Communication\nCommunicate data requirements and discrepancies to credentialing, enrollment, and provider relations teams.\nProvide clear documentation for provider updates and requests.\nProcess Improvement & Tooling\nRecommend system enhancements, automation opportunities, and updated workflows.\nSupport implementation of new processes, templates, and operational tools.\nWork Requirements\nYears of Experience\n3 + years of related experience\nmay vary based on technical training, certification(s), or degree\nCertification\nTravel Required\nLess than 10%\nSalary and Benefit Information\nThe likely salary range for this position is $46,325 - $62,675. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.\nOur Identity Verification Process\nAs part of the hiring process, we will ask you to complete an identity verification process that leverages advanced biometrics and artificial intelligence to ensure authenticity and protect against identity fraud. You are expected to be on camera during virtual interviews. We reserve the right to take your picture to verify your identity and prevent fraud. By proceeding, you authorize the collection, processing, and use of your biometric data for identity verification and security purposes.\nAbout Our Work\nWe are GDIT. 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. Our 26,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50+ countries worldwide, offering leading mission-ready capabilities in AI, cloud, cyber and software development.\nJoin our Talent Community to stay up to date on our career opportunities and events at gdit.com/tc.\nEqual Opportunity Employer / Individuals with Disabilities / Protected Veterans","datePosted":"2026-08-12T13:51:39.829Z","dateModified":"2026-08-12T13:51:39.829Z","hiringOrganization":{"@type":"Organization","name":"General Dynamics Information Technology","sameAs":"https://jobsearcher.com"},"jobLocation":{"@type":"Place","address":{"@type":"PostalAddress","addressLocality":"Falls Church","addressRegion":"VA","addressCountry":"US"}},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"034d61a63a79cd6eadd6d97f"},"url":"https://jobsearcher.com/jobs/034d61a63a79cd6eadd6d97f"}}