Provider Information Management
Found in: Lensa US P 2 C2 - 1 week ago
The Provider Information Management (PIM) Coordinator position acts as a liaison between our IPAs and contracted health plans and manages provider data.
With approximately 9,000 physicians to serve our 260,000 members, Prospect Medical Systems is proud to be among the most innovative medical systems in California, Texas and Rhode Island. Our extensive care services range from primary care and specialty physician services to acute care hospital and skilled nursing facilities to behavioral health and wellness services. Each of our Independent Physician Associations (IPAs) and networks support the use of advanced diagnostic and treatment tools to provide our members with convenient access to state-of-the-art healthcare. For 25+ years, Prospect Medical has been focused on our mission of supporting independent physicians where, through risk arrangements, we work closely together with health plans, facilities and healthcare physicians for the benefit of every person who comes to us for care. We provide quality healthcare services that are designed to offer our patients highly coordinated, personalized care and that help them live healthier lives. Prospect Medical Systems manages highly successful IPAs by leveraging our best-practices, results-driven administrative services to manage patients under risk arrangements with health plans/CMS.- Responsible for timely and accurate processing of provider change forms.
- Responsible for the submissions to contracted health plans for applicable network(s).
- ?Responsible for provider listing maintenance and follow-up with health plans to ensure that all submissions have been processed appropriately.
- Responsible for obtaining PCP ID Numbers from contracted health plans and entering data
- Ensure accuracy of provider information stored in database.
- Manages request/inquires that come from health plans as well as other departments.
- ?Manages validation of provider roster; verifying the accuracy and ensuring roster is completed.
Minimum Education: ?High School Diploma or equivalent.
Minimum Experience: Previous experience with IPA/Medical Group required.
Req. Certification/Licensure: None.
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