Provider Maintenance Tech

Integrated Resources Inc.; Philadelphia (Philadelphia County); On-site; USD 40,000 - 55,000; Full time

Job summary

A leading healthcare company is seeking a Provider Maintenance Technician I to manage the provider database and ensure accurate provider records. Successful candidates will possess an Associate's degree, strong data entry skills, and experience in healthcare. This role involves supporting various projects and ensuring compliance with corporate standards.

Qualifications

• 1+ year previous experience with claims and provider demographic information.
• 2+ year’s previous data entry experience.
• Proficiency with medical terminology.

Responsibilities

• Maintain provider database for participating and non-participating providers.
• Research and resolve returned provider correspondence.
• Adhere to ACFC policies and procedures.

Skills

MS Excel

Medical terminology

Provider demographic information

Data entry

Education

Associates’ Degree or equivalent

Tools

Facets

EXP Macess

Job description

• Associates’ Degree or equivalent combination or education and work experience preferred.

Experience:

• 1+ year previous experience working with claims and/or provider demographic information.
• 2+ year’s previous data entry experience.
• Ability to use MS Excel to manage work items and manipulate data.
• Previous experience working with healthcare providers
• Proficiency with medical terminology
• Previous experience working with Facets preferred
• Previous experience working with EXP Macess preferred.

Position Summary:

Under the direct supervision of the Provider Maintenance Supervisor, the Provider Maintenance Technician I is responsible for maintaining both participating and non-participating provider records in the provider database. Demonstrates and supports commitment to corporate goals and mission. Required to attend training on an as needed basis. Performs other related duties and projects as assigned.

Principal Accountabilities:

• Maintains the provider database for both participating and non-participating provider adds, changes and terminations.
• Researches and resolves returned provider correspondence.
• Responsible for working on projects assigned by Supervisor.
• Performs other related duties and projects as assigned.
• Adheres to ACFC policies and procedures.
• Attends required training on an annual basis.

Key Competencies/Success Factors:

• Ability to enter/change provider information in Facets and meet the minimal accuracy standard.
• Meets turn-around time standard for provider additions, changes and terminations and all work assigned according to the deadline assigned.
• Demonstrates excellent judgment and decision-making skills to complete assignment accurately and timely.
• Demonstrates flexibility and team support to ensure efficient, effective operations, which crosses all LOBs.
• Ability to respond to extreme needs such as backlogs and staff constraints by contributing above and beyond routine work effort and hours.
• Ability to work well with co-workers and create a positive work environment
• Demonstrates a willingness and aptitude to be cross-trained in other functions to ensure efficient operations during times of peak volume or low staffing.

Additional Information

All your information will be kept confidential according to EEO guidelines.