Provider Information Management (PIM) Coord

Remote: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

Five years of experience in credentialing or contracting in a hospital or IPA setting., High school diploma or GED required; Bachelor's in Business Administration preferred., Training in provider information management is advantageous., Strong attention to detail and quality assurance skills are essential..

Key responsabilities:

  • Process provider change forms accurately and in a timely manner.
  • Maintain provider listings and follow up with health plans on submissions.
  • Conduct audits of new employee work before submission to health plans.
  • Educate staff on updates and improvements related to health plans.

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Prospect Medical Systems SME https://prospectmedicalsystems.com/
501 - 1000 Employees
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Job description

Job Description

The Provider Information Coordinator is responsible for submission of data provided to the health plan, quality assurance of rosters and identifying trends. In addition to assisting in educating the staff on improvements and updates of health plans.

Responsibilities

Responsible for timely and accurate processing of provider change forms.| Responsible for the submissions to contracted health plans for applicable network.| Responsible for provider listing maintenance and follow-up with health plans to ensure that all submissions have been processed appropriately.| Audit new employees work prior to submission to health plans within thirty (30) days of training.|Review Change Form on CDA, Morrisey reports, emails submitted to health plans. Review PID retrieval and resubmission process. Quality review of rosters submitted to health plans.| Assists in educating and updating the PIM/Credentialing Department on new guidelines.| Resource for training, education and coordination of improvements and additions. Weekly review of reports to identify areas for training.| Identify trends and report to management.

Qualifications

Five (5) years' experience and/or training in credentialing and/or contracting in a hospital or IPA setting. High school diploma or GEDBachelors in Business Administration or equivalent from a four year college or technical school preferred.

Required profile

Experience

Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Quality Assurance
  • Problem Reporting
  • Training And Development

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