Provider Services Specialist
2 weeks ago
Overview
The role involves engaging in the conversion of provider agreements into system configurations to ensure precise data management within Parkview Health systems. This includes maintaining provider demographic information and conducting fee schedule assessments for Health Plan Services (HPS) in collaboration with HPS Business Analysts.
Responsibilities include examining fee schedules and reimbursement strategies, as well as contributing to the formulation of pricing suggestions. This encompasses validating claims processing accuracy against system configurations, reviewing fee schedules, and addressing contract-related concerns.
Effective communication, both verbal and written, is essential for interactions with Contract Specialists and Management, as well as with the provider network. The position demands a commitment to delivering exceptional customer service to both internal and external stakeholders.
Qualifications
Education
Required: A Bachelor's degree in a healthcare or finance-related discipline.
Licensure/Certification
Must possess a valid state-issued driver's license.
Experience
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.
Additional Skills
Strong verbal and written communication abilities are essential. Candidates must have reliable transportation and may be required to work outside the office environment approximately 5% of the time. Excellent time management skills are crucial, with an emphasis on effectively balancing remote and in-office work.
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Provider Services Specialist
2 weeks ago
Fort Wayne, Indiana, United States Parkview Health Full timeOverview 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...
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Provider Services Specialist
2 weeks ago
Fort Wayne, Indiana, United States Parkview Health Full timeOverview The role involves engaging in the translation of provider agreements into system configurations to ensure precise data management within Parkview Health systems. This includes overseeing provider demographic information and conducting fee schedule assessments for Health Plan Services (HPS) in collaboration with HPS Business Analysts. Analyzes fee...
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