Mendry · Florida 501(c)(3) Nonprofit · Veteran-Built & Independent

Mendry

DCSP Hub · Hub 02

Role

of 09

Enrollment

The gateway between provider and payer.

CAQH

ProView · DirectAssure

NCQA

Provider Network Standards

CMS PECOS

Federal Enrollment

STATE MEDICAID

State-Specific Enrollment

01 Provider Enrollment Specialist A Provider Enrollment Specialist onboards credentialed providers into payer networks — submitting… Series 02 Provider Enrollment Coordinator A Provider Enrollment Coordinator manages enrollment workflow across multiple providers, multiple payers,… Series 03 Provider Data Specialist A Provider Data Specialist maintains the accuracy of provider information across every… Reading 04 Provider Relations Representative A Provider Relations Representative serves as the bridge between practices and the… Up Next 05 Provider Network Coordinator A Provider Network Coordinator builds and maintains the geographic and specialty composition… Series 06 Payer Enrollment Specialist A Payer Enrollment Specialist handles enrollment across multiple payers simultaneously — VA… Series 07 CAQH Profile Manager A CAQH Profile Manager maintains the CAQH ProView profiles that serve as… Series 08 Primary Source Verification (PSV) Specialist A Primary Source Verification (PSV) Specialist verifies provider credentials directly from issuing… Series 09 State Medicaid Enrollment Specialist A State Medicaid Enrollment Specialist navigates state-specific Medicaid programs and the Managed… Series

DCSP Hub · Enrollment

Role

of 09

Provider Data Specialist

A Provider Data Specialist maintains the accuracy of provider information across every directory, every payer database, and every public-facing listing where the practice’s providers appear. The work is increasingly critical as the No Surprises Act and CMS provider directory requirements impose accuracy mandates with real financial penalties. Bad provider data costs practices money. Good provider data — current, accurate, consistent across systems — protects revenue and compliance posture.

How This Work Happens

Provider data specialist work happens in three places: as a hospital or health-system employee, as a contractor working through a credentialing services company, or as an independent business owner. This page covers all three so you can choose the path that fits your life.

Mendry supports the third path. We are a Florida 501(c)(3) membership platform full of opportunities — not an employer, not a placement agency. We list independent professionals so the practices that need them can find them. Your business. Your contracts. Your rates. Your decisions.

MEMBER ACKNOWLEDGMENT

Membership in Mendry’s DCSP Network is built on these understandings about your business.

Fifteen points. Read carefully. This is the agreement.

You set your own rates. Mendry does not suggest, publish, recommend, or facilitate the sharing of rate information between members.

You bill your own clients and collect your own payment. Mendry does not invoice, collect, hold, distribute, or process payment between you and your clients.

You hold and maintain current professional liability and errors-and-omissions insurance appropriate to your specialty. Mendry does not insure you, indemnify you, or provide coverage of any kind.

You handle your own taxes as an independent business. Mendry does not withhold, report, file, or remit taxes for you. You are responsible for federal, state, and local tax obligations including estimated quarterly payments.

You sign your own contracts directly with your clients. Mendry is never a party to, signatory of, or guarantor of your client agreements, and Mendry does not negotiate, review, or approve your contract terms.

When your work touches Protected Health Information (PHI), you execute a Business Associate Agreement (BAA) directly with each client before beginning work. Mendry is never a party to your BAAs, and Mendry’s website never touches, stores, or transmits PHI.

You hold and maintain all federal, state, and local business licenses, registrations, and certifications your business and work require. Mendry does not verify licenses on your behalf or vouch for your licensure status.

You complete the continuing education your credential requires and maintain current documentation. Mendry does not track CE on your behalf, report CE to credentialing bodies, or guarantee that your CE meets any specific requirement.

You carry full professional responsibility for the quality, accuracy, and timeliness of your work product. Errors, omissions, missed deadlines, and quality disputes are between you and your client. Mendry does not mediate, intervene, indemnify, or carry any liability for your work.

You market your own business and represent yourself accurately to clients. You do not represent yourself as employed by, certified by, endorsed by, or operating under the authority of Mendry. You may accurately state that you are a listed member of the Mendry DCSP Network.

Your professional relationships are with your DCP clients. You do not have a direct service relationship with veterans through Mendry, and Mendry does not refer veterans to you as patients or clients.

You maintain your own client records, working files, and business records on systems and tools you control. Mendry does not host, back up, store, or have access to your client files or business data.

Your membership in the DCSP Network is conditional on maintaining current credentials, insurance, licenses, and good standing. Mendry may suspend or terminate your directory listing if these standards lapse.

Your membership fee pays for your listing and the educational resources Mendry provides. It does not buy referrals, leads, work, or placement, and is not refundable based on the work you do or do not receive.

You are a member of an independent professional directory. You are not an employee, contractor, agent, partner, joint venturer, or representative of Mendry. Mendry does not direct, supervise, control, schedule, or assign your work.

What This Really Means

The same fifteen points — explained the way a friend would explain them.

01 You decide what to charge.

You research what other professionals in your specialty charge. You look at job boards. You ask peers. You decide what your work is worth, and you tell your clients that number. Mendry does not tell you what to charge. We do not share rate information. That keeps us out of antitrust trouble and keeps you free to price your work the way you choose.

02 You send the bill. You collect the money.

Every month, you send your client an invoice. The client pays you directly — usually by ACH bank transfer or check. Mendry does not touch the money. We never see your invoices. We never collect for you. Money flows from client to you. Period.

03 You buy your own insurance.

Professional liability insurance protects you if a client says your work cost them money. Errors and omissions insurance protects you if you make a mistake in your work product. Every working DCSP needs both. You shop for it. You pay for it. You keep it current. Mendry does not insure you, and the directory does not list you as covered by us.

04 You pay your own taxes — four times a year.

As an independent business, you pay estimated taxes every quarter — April, June, September, and January. You file a Schedule C with your tax return. Mendry does not withhold anything. We do not report your income to the IRS. You are responsible for tracking your income, your expenses, and your tax payments. A bookkeeper or CPA pays for itself.

05 You sign your own contracts.

Every client gives you a contract — sometimes called a Master Service Agreement or a Statement of Work. You read it. You sign it. If something looks off, you take it to your own attorney. Mendry does not read your contracts, does not negotiate them, and is not a party to them.

06 You sign a BAA with every client before you start.

When your work touches information about real patients — their names, dates of birth, diagnoses — that information is called PHI. Before any client lets you near their patient information, you sign a Business Associate Agreement. Every client. Every time. Mendry’s website never touches PHI — we educate you about it, that’s it.

07 You hold your own business licenses.

Some states require a business license to operate. Some cities require a local one. You research what your state and city require, and you hold whatever licenses apply. Mendry does not verify your licenses for you — the verification badge on your directory profile reflects what you upload, not what we check with the state.

08 You keep your credentials and CE current.

Your professional credential needs continuing education hours to stay active. You complete the CE. You track the hours. You report them to your credentialing body. Mendry does not report for you and does not guarantee your CE is enough — that’s between you and your credentialing body.

09 You own the quality of your work.

If you make a mistake in your work, the client may lose money. They may ask you to fix it. They may charge you for the loss. Your insurance and your reputation handle this — not Mendry. Build clean files. Communicate well. Hit your deadlines.

10 You market yourself accurately.

You can tell clients: “I am a listed member of the Mendry DCSP Network.” That is accurate. You cannot tell clients: “I work for Mendry” or “Mendry certified me.” Stick to “listed member of the directory.”

11 Your clients are DCP practices. Veterans are not your clients.

You serve the doctor’s practice or the clinic — the DCP. The veteran is the DCP’s patient, not yours. Mendry does not refer veterans to you. The chain goes: Mendry lists DCPs. DCPs hire DCSPs. DCSPs serve DCPs. You are two steps removed from the patient, which is exactly where you should be.

12 You keep your own records.

Your client files, your invoices, your work product, your tax records — all of it lives on systems you control. Mendry does not host your work. We do not back up your data. Use cloud backup. Treat your business like a real business.

13 Your directory listing is conditional, not permanent.

If your credential lapses, your listing pauses. If your insurance expires, your listing pauses. Membership is a standing — you maintain it by keeping everything current. We send you reminders before things lapse. The directory only works if every member listed is actually current.

14 Your membership fee pays for listing — not for leads.

Mendry does not promise you work. The fee you pay covers your spot in the directory and the educational resources we publish. Whether you win the work after that depends on you — your profile, your responsiveness, your rates, your references. Membership is an opportunity, not a guarantee.

15 You are a member. We are a platform. That is the whole relationship.

Mendry does not employ you. We do not contract with you. We do not represent you. We list you. You operate your business. The line between us is clean and clear — and the clean line is what protects both of us.

What This Role Involves

Provider Data Specialists run the data hygiene that keeps every provider listing accurate across payer directories, CAQH ProView, practice websites, Google Business listings, and the multiple payer-specific portals that all need to reflect the same provider information at the same time.

Inaccurate provider data has real consequences. The No Surprises Act requires plans to verify provider directory accuracy quarterly; providers whose information is incorrect can be removed from the directory. CMS imposes financial penalties on Medicare Advantage plans with directory errors. Patients leave reviews about appointments scheduled with providers who no longer practice at the listed location. The Provider Data Specialist prevents all of this.

The work intersects with credentialing, enrollment, marketing, and IT. Provider Data Specialists work across departmental lines — partnering with Credentialing on verified information, with Enrollment on payer directory updates, with marketing on website accuracy, and with IT on data integration between practice management systems and external directories.

The Honest Description

The Provider Data Specialist role rewards systematic thinking and attention to data consistency. Members who do well in this work enjoy spotting where the same information disagrees across systems, take pride in directory accuracy, and find satisfaction in preventing the small data errors that create big compliance problems.

The Core Activities

1

Maintain provider data across all directories

Update CAQH ProView, payer portals, practice websites, Google Business listings, and any other public-facing provider directory whenever provider information changes.

2

Audit data consistency across systems

Periodically verify that the same provider’s information matches across every system. Identify and resolve discrepancies.

3

Manage CAQH ProView attestations

Coordinate every provider’s CAQH attestation every 120 days. Verify data accuracy before each attestation. CAQH is the single source of truth for many payer directories.

4

Support No Surprises Act compliance

Respond to plan accuracy verification requests within required timelines. Document responses. Prevent providers from being removed from directories due to non-response.

5

Coordinate with marketing and IT

Ensure provider data on practice websites and marketing materials stays consistent with payer directory data. Work with IT to automate data integration where possible.

Where This Role Appears in the Field

In a hospital or health system

Hospital provider data specialists work within credentialing or medical staff offices. Larger systems may have dedicated provider data teams.

In a credentialing services company

Service companies offer provider data management as a specific service to client practices. Strong remote-work potential.

As an independent contractor

Practices struggling with No Surprises Act compliance or directory accuracy issues hire independent specialists to audit and remediate provider data across their systems.

Federal Payer Workflow

VA CCN, TRICARE & CHAMPVA Credentialing

VA Community Care Network directories are maintained by Optum and TriWest in their respective regions. Provider data accuracy in these directories affects veterans’ ability to find appropriate care providers. Specialists serving practices in VA CCN need to know each regional administrator’s directory update workflow.

TRICARE and CHAMPVA directories follow their own accuracy verification cycles. Specialists who manage provider data across federal payer directories alongside commercial directories become particularly valuable as multi-payer practices increasingly need unified data management.

The two-hat reality. In a two-hat practice, this work runs on two parallel tracks at once — VA Community Care credentialing and claims under federal authority, and state medical cannabis practitioner participation under state authority. The two tracks never share a workflow, but they share a deadline: a lapse on either side stops payment and access on both. Members who can hold both tracks steady at the same time are the ones two-hat practices keep.

Your Roadmap to becoming an independent Provider Data Specialist

This is the step-by-step path. Follow each step in order.

Step

Build foundational enrollment or credentialing knowledge

Most provider data specialists come from enrollment or credentialing backgrounds. Understanding what data needs to match and why comes from working with the source systems.

Step

Develop systems and data skills

Excel proficiency, basic database concepts, and familiarity with data audit techniques are valuable. Some specialists add SQL or healthcare data analytics training.

Step

Set up your business

Step

Get professional liability insurance

Errors and omissions coverage. Directory accuracy errors can lead to compliance findings, so coverage matters.

Step

Sign HIPAA Business Associate Agreements

Every client signs a BAA. Provider data work involves provider personal information.

Step

Find your first client

Practices facing No Surprises Act compliance audits or with directory accuracy issues are natural first clients.

Step

List in the Mendry DCSP Network

Position yourself around No Surprises Act compliance and directory accuracy — these are specific pain points practices actively search for help with.

Step

Build your book of business

Data specialists often work on project engagements (audit, remediate, deliver) plus ongoing maintenance retainers. Three to five steady client retainers can support a full independent practice.

Education & Experience Pathways

Members exploring this role typically come into the work through one of these learning paths:

Enrollment professional transitions

Experienced Provider Enrollment Specialists who understand payer directory systems transition naturally into data specialist work.

Healthcare IT backgrounds

Healthcare IT professionals with data management experience bring complementary skills — the technical side of how directories integrate with practice management systems.

Military MOS adjacent paths

Military intelligence analysts and administrative roles with data accuracy responsibilities translate well — 35F (Intelligence Analyst), 25B (Information Technology Specialist with data focus), 3D1X3 (RF Transmission Systems with attention-to-detail requirements).

The Skill That Distinguishes Strong Specialists

Provider Data Specialists who grow fastest are the ones who build audit tools that automate consistency checking across multiple systems. Manual cross-reference checking does not scale. A specialist who can build a tool that flags data discrepancies automatically becomes essential to clients who outgrow manual review.

The Realities of the Work

The Provider Data Specialist role is data-focused work that requires sustained focus. You spend significant time in spreadsheets, payer portals, and CAQH ProView, comparing data across systems and updating inconsistencies.

It is remote-work friendly. Almost all provider data work can be done from home with secure access. Compensation is improving as the No Surprises Act compliance burden increases practice demand for the specialty.

Income — Research the Range

Mendry does not publish specific income figures because numbers vary based on credential, geographic market, employment type, specialty focus, and experience. Here are the authoritative sources to research current income data:

BLS — Medical Records Specialists

BLS data covering provider data work within the broader credentialing and enrollment category.

bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm

CAQH — Industry Publications

CAQH publishes industry research on provider data accuracy, directory maintenance, and the cost of inaccurate data.

caqh.org

FlexJobs & Upwork — Independent Contractor Rates

Real-time rate data for provider data management work.

flexjobs.com · upwork.com (search "provider data")

Indeed & Glassdoor — Real-Time Market Data

Active market data for provider data specialist positions.

indeed.com · glassdoor.com (search "provider data specialist")

How to Know If This Role Fits You

The Provider Data Specialist role is a good fit for members who like systematic data work, enjoy spotting inconsistencies, and find satisfaction in clean, accurate records. It is not for members who want lots of human interaction or fast-paced variety. But for the right person, especially with growing No Surprises Act compliance demands, it is one of the fastest-growing specialty paths in healthcare administration.

About this content. Mendry is a Florida 501(c)(3) nonprofit membership platform. This page is educational and does not constitute medical, legal, financial, or placement advice. Enrollment requirements, payer policies, and network standards vary by payer, state, and accreditation body. Always confirm current requirements with the relevant payer or authority before making professional decisions. Mendry does not employ, place, refer, or supervise enrollment professionals. All members listed in the DCSP Network operate their own independent businesses, set their own rates, sign their own contracts, and carry their own insurance. Mendry does not provide treatment, prescribe or sell cannabis, complete state forms, or collect PHI. Emergency: 911 · Veterans Crisis Line: 988 (Press 1) · Text 838255.

Your Specialty. Your Business. Your Network.

Mendry lists independent credentialing professionals so the two-hat practices that need them can find them. Your business, your rates, your clients, your decisions — we provide the visibility and the platform.