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Providence Health & Services Provider Relations Coordinator - Mission Hills in Mission Hills, California

Description:

Apply today! Applicants that meet qualifications will receive a text with additional questions from our MODERN HIRE screening and interview system.

Providence is calling a Provider Relations Coordinator (Full-Time/Day Shift) to Providence Medical Insitute in Mission Hills, CA.

The schedule for this position is Mon-Fri 8:00am – 5:00pm.

Please upload a current resume reflecting all relevant experience.

We are seeking a Provider Relations Coordinator who will be responsible for maintaining provider information in internal databases and files; ensures the accuracy and completeness of provider data as reflected in the Health Plan directories; distributing information and reports; communicating with Health Plans regarding provider updates; researching and resolving inconsistent data; assisting in taking incoming calls from providers, patients or vendors, supporting the Customer Relations department as needed and maintains strict confidentiality.

The incumbent performs all duties in a manner that promotes Providence mission, values, and philosophy. In all aspects, he/she serves as a role model for the values and mission of the organization.

In this position you will:

  • Establish and maintain all new and existing provider files, including credentialing profiles and correspondence.

  • Work closely with various staff/departments to obtain documentation required for health plan notification.

  • Maintain provider databases, including data entry. Maintain provider rosters.

  • Confer with Medical Group Site Directors to determine PCP assignment.

  • Coordinate notification of provider updates to health plans including supporting documentation.

  • Follow up with health plans to ensure provider updates were received and set up correctly in health plan databases/websites. Obtain PCP ID numbers from each health plan.

  • Review and survey health plan websites to confirm provider set up. Reconcile inaccurate information with health plan. Notify Health Plan if members are incorrectly assigned to termed providers.

  • Reconcile provider rosters with health plans on a quarterly or annually as applicable.

  • Respond to inquiries from internal departments, health plans or patients regarding Primary Care Provider assignment issues.

  • Provide administrative support to department Administrative Director and Manager.

  • Perform secretarial duties including typing, proofreading, composition, correspondence, indexing and filing. Creates and maintains files and binders as needed.

  • Attend meetings as assigned and takes minutes and keeps appropriate records. Follows up on all matters as needed.

  • Handle confidential matters concerning provider information, office policies and practices. Maintains strictest confidentiality.

  • Meet operating performance standards established by the MSO.

  • Adhere to safety policies and standards.

Qualifications:

Required qualifications for this position include:

  • Two (2) years experience in general healthcare, administrative support services, provider and customer service work environment.

  • Successful experience in administrative functions and a working knowledge of health care administration practices, managed care systems, customer service and provider relations.

  • Experience with creating and compiling spreadsheets.

  • Effective communication and computer skills are critical as are good judgment and decision-making skills.

  • Strong attention to detail, interpersonal relations and team building skills are a requirement for internal and external purposes.

  • Possesses clear set of personal, organizational and societal values. Knowledge of and commitment to the application of Catholic/Christian health care ministries, principles and values.

  • Working knowledge & understanding of health plan payors - HMO & PPO and provider credentialing.

  • Detail oriented with good problem solving skills. Skill in gathering and analyzing information.

  • Organizational skill with ability to maintain accurate provider files.

  • Proficient in MS Office programs.

  • Excellent written and verbal communication skills.

  • Ability to answer calls and provide information to patients, providers, health plans & vendors.

  • Ability to work collaboratively with other operational units within Providence Health & Services.

  • Ability to perform at high level in an environment of rapid growth, constant change and sometimes ambiguous circumstances.

Preferred qualifications for this position include:

  • Bachelor's Degree in Health care administration, business administration or related area or Equivalent work experience in health care, insurance or credentialing.

  • Work history emphasis within a medical group, independent physician association, management services organization or physician hospital organization.

About the hospital you will serve.

Providence Health & Services is further developing its physician integration strategy. Historically, the largest asset has been Providence Medical Institute, a medical foundation that provides administrative and other support services to affiliated medical groups. Providence Medical Institute is expected to grow significantly in the next several years, bringing with it facilities, staff and physician growth to support that objective.

For information on our comprehensive range of benefits, visit:

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Analytics/Business Intelligence

Location: California-Mission Hills

Req ID: 289682

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