Provider Services Specialist

2 weeks ago


Fort Wayne, Indiana, United States Parkview Health Full time

Overview


The role involves contributing to the translation of provider agreements into system configurations, ensuring precise data management within Parkview Health systems. This includes maintaining provider demographic information and conducting fee schedule assessments for Health Plan Services (HPS) alongside HPS Business Analysts.

Engagement in the analysis of fee schedules and reimbursement strategies is essential, as well as participating in the formulation of pricing proposals. This encompasses claims processing verification for accuracy in relation to system configurations, reviews of fee schedules, and addressing contract-related concerns.

Effective communication, both verbal and written, is crucial for liaising with Contract Specialists and Management, as well as with the provider network. The position emphasizes delivering exceptional customer service to both internal and external stakeholders.

Qualifications

A Bachelor's degree in a healthcare or finance-related discipline is required.

Licensure/Certification

A valid state-issued driver's license is mandatory.

Experience


A minimum of four years of extensive experience in managed healthcare, provider relations, project management, medical informatics, utilization management, or experience within a physician's office is necessary.


Additional Skills

Exceptional verbal and written communication abilities are essential. Candidates must have their own transportation and may be required to work outside the office approximately 5% of the time. Strong time management skills are a must, along with the ability to effectively balance remote and in-office work opportunities.

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