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Provider Maintenance & Network Specialist

United States - Remote

Point C is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. Our commitment and partnership means thinking beyond the typical solutions in the market – to do more for clients – and take them beyond the standard “Point A to Point B.” We have researched the most effective cost containment strategies and are driving down the cost of plans with innovative solutions such as, network and payment integrity, pharmacy benefits and care management. There are many companies with a mission. We are a mission with a company.

We’re seeking a detail-oriented and tech-savvy Provider Maintenance / Network Specialist to join our growing team. In this role, you’ll manage the accuracy of provider data, support network updates, and ensure that claims process correctly through accurate provider and network configuration. 
 
Key Responsibilities
  • Maintain and update provider information in internal systems (address changes, TINs, specialties, affiliations, etc.).
  • Support network setup and maintenance, ensuring providers and facilities are correctly tied to networks and fee schedules.
  • Collaborate with claims, eligibility, and client services teams to troubleshoot provider data or network discrepancies.
  • Process provider additions, terminations, and demographic updates within established turnaround times.
  • Assist in validating provider credentialing data and confirm network participation details.
  • Review reports and system audits to identify and correct provider or network data inconsistencies.
  • Coordinate with external partners (vendors, repricers, and networks) to ensure seamless data exchange.
  • Support special projects involving provider file loads, network configurations, or data cleanup efforts.
  • Maintain compliance with company procedures, HIPAA regulations, and client requirements.
Qualifications Required:
  • Strong attention to detail and ability to maintain data accuracy across multiple systems.
  • 1–2 years of experience in a healthcare or insurance environment.
  • Excellent organizational and analytical skills.
  • Proficiency in Excel and comfort working with large datasets.
  • Strong communication and follow-up skills.
  • Tech-savvy and able to learn new systems quickly.
Preferred Qualifications:
  • Experience working for a Third Party Administrator (TPA), health plan, or repricing/network vendor.
  • Familiarity with provider data maintenance, network configuration, or claim routing logic.
  • Understanding of healthcare provider types, specialties, and billing concepts.
  • Experience with EDI files, provider file loads, or database-driven systems.

Individual compensation will be commensurate with the candidate's experience and qualifications. Certain roles may be eligible for additional compensation, including bonuses, and merit increases. Additionally, certain roles have the opportunity to receive sales commissions that are based on the terms of the sales commission plan applicable to the role.

Pay Transparency

$40,000 - $41,000 USD

Benefits:
  • Comprehensive medical, dental, vision, and life insurance coverage
  • 401(k) retirement plan with employer match
  • Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)
  • Paid time off (PTO) and disability leave
  • Employee Assistance Program (EAP)

 

Equal Employment Opportunity: At Point C Health, we know we are better together. We value, respect, and protect the uniqueness each of us brings. Innovation flourishes by including all voices and makes our business—and our society—stronger. Point C Health is an equal opportunity employer and we are committed to providing equal opportunity in all of our employment practices, including selection, hiring, performance management, promotion, transfer, compensation, benefits, education, training, social, and recreational activities to all persons regardless of race, religious creed, color, national origin, ancestry, physical disability, mental disability, genetic information, pregnancy, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, and military and veteran status, or any other protected status protected by local, state or federal law.

 

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