What are the responsibilities and job description for the Provider specialist position at PGBA?
Description
What You’ll Do :
Verifies necessary / needed information (written notifications, faxes, emails, or telephone contacts) and / or establishes certification of healthcare service providers.
Prepares provider files and maintains provider data (updates, additions, deletions) on the provider information management system (PIMS) or appropriate provider system / database.
Identifies / assigns providers to the appropriate network and provider system / database.
Contributes to the department's production standard by working on PIMS and AMMS (automated medical management systems) or appropriate provider system / database maintenance / error reports.
Contributes to and participates in special projects, which may include, but are not limited to, mass rate updates, quality improvement, audits, etc.
Work environment : Typical office environment. Some travel may be required.
To Qualify for This Position, You’ll Need :
High School Diploma or equivalent.
One (1) year of administrative / clerical support, customer service, claims processing, and / or provider network / certification experience.
Working knowledge of word processing and spreadsheet software.
Knowledge / understanding of or ability to acquire PIMS.
Good judgment skills.
Effective customer service and organizational skills.
Demonstrated verbal and written communication skills.
Basic business math proficiency.
Ability to handle confidential or sensitive information with discretion.
Microsoft Office.
We Prefer That You Have :
Ability to learn DB2 and SQL language to create / run PIMS queries for QC / research purposes.
What Blue Can Do For You :
Our comprehensive benefits package includes :
401(k) retirement savings plan with company match
Subsidized health plans and free vision coverage
Life insurance
Paid annual leave the longer you work here, the more you earn
Nine paid holidays
On-site cafeterias and fitness centers in major locations
Tuition assistance
Service Recognition
What to Expect Next :
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications.
This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
Management will be conducting interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications.
Last updated : 2024-07-02
