Role: PDM Analyst – BPMJob Summary The PDM Analyst will be responsible for reviewing, validating, updating, and maintaining accurate provider information within a US Healthcare BPM environment. The role involves provider data management, outreach verification, returned mail processing, credentialing record updates, and PIMS claims-related provider setup while ensuring compliance with defined quality, productivity, SLA, and turnaround-time requirements.

Key Responsibilities

Provider Data Management

- Review and process provider update requests.
- Validate and update provider demographics, addresses, specialties, affiliations, and practice locations.
- Maintain accurate provider records and supporting documentation.
- Identify incomplete, inconsistent, or conflicting information and escalate as required.

Provider Outreach & Verification

- Contact providers through email or telephone to verify information.
- Document outreach attempts, responses, and validation outcomes.
- Ensure provider updates are supported by appropriate evidence before closure.

Returned Mail

- Review returned mail cases and validate provider address information.
- Update applicable systems with verified information.
- Escalate unresolved discrepancies or network-access concerns.

Credentialing & Recredentialing

- Review credentialing records and update information as per approved procedures.
- Validate required documentation and identify missing or inconsistent information.
- Support recredentialing activities,



primary source verification, and compliance checks as applicable.

PIMS Claims Support

- Review claims pended due to missing group or practitioner information.
- Research and update missing provider information in the designated system.
- Validate provider data to support downstream claims processing.
- Escalate unresolved records appropriately.

Quality & Operations

- Manage assigned inventory and meet productivity, quality, SLA, and TAT requirements.
- Perform self-quality checks and resolve defects.
- Maintain accurate trackers, dashboards, case notes, and status records.
- Support backlog reduction, aging control, audits, and continuous improvement initiatives.

Mandatory Skills Provider Data Management | Provider Credentialing | CAQH | NPDB | US Healthcare | Claims Management | Provider Operations | BPM/BPO

Preferred Skills

NPPES | OIG | Recredentialing | Provider Outreach | PIMS | Healthcare Payer Operations | Microsoft Excel

Qualifications & Experience

- Bachelor's degree in Healthcare Administration, Business, Life Sciences, or related field preferred.
- 3–6+ years of experience in US Healthcare Provider Data Management, Credentialing, Recredentialing, or Provider Operations.
- Healthcare Payer/BPO/BPM experience preferred.
- Solid attention to detail, documentation, analytical, communication, and problem-solving skills.

Pay: ₹60,000.00 - ₹100,000.00 per month

Work Location: In person

📌 PDM Analyst – BPM(Associate III - BPM- PDM) (Thiruvananthapuram)
🏢 Knowledge Artisans Private
📍 Thiruvananthapuram