Provider Services Specialist - Aspire Health Plan

Welcome to Montage Health’s application process!

Job Description:

Purpose of Position

The Provider Services Specialist is responsible for supporting all functions of the Provider Services Department. The Provider Services Specialist will work closely with the Provider Network Credentialing Manager to ensure that all contracted providers, facilities and organizations are credentialed in a timely manner as well as provide ongoing oversight of contracted provider’s licensing and credentials. This position will focus on maintaining the highest level of accuracy for all provider data.

Responsibilities

• Data entry of all provider data into all applicable systems and databases.
• Monthly ongoing monitoring of expirable documents and follow-up with providers to obtain any needed documentation to keep all expirables up to date.
• Maintains accuracy of provider database and all published directories through maintenance and directory validation audits. 
• Assist with preparations for applicable committees and Board activities.
• Monitors licensing boards for sanctions, accusations and disciplinary actions, and follows up accordingly.
• Corresponds with licensing boards, hospitals, specialty boards, training programs, medical groups, practitioners, office staff, contracting, and management to conduct primary source verification or to resolve issues.
• Manages special projects related to Provider Services, collaborating with other departments as necessary.
• Assists in preparation for state and federal audits and surveys Create and maintain filing systems, both electronic and physical.
• Other duties as assigned.

Competencies

• Accountability and Dependability: Assumes responsibility for accomplishing duties in an effective and timely manner.
• Integrity:  Consistently honors commitments and takes responsibility for actions and words. 
• Software and Computer Skills: Proficient in the use of Microsoft Office Suite. Highly skilled at using the Internet. Learns effectively with computer-based and/or online training.
• Flexibility:  Demonstrates adaptability and openness to alternative solutions and flexibility when interacting with others, understanding their attitudes, needs, interests, and perspectives.
• Inclusiveness:  The ability to network and partner with all internal and external stakeholders including broad and diverse representation of private/public and traditional/non-traditional community organizations.

Position Requirements

• Solid Medical Terminology knowledge.
• Microsoft Office Suite knowledge.
• Excellent organization skills and a keen attention to detail.
• Knowledge of healthcare reimbursement is helpful.
• Ability to participate in and support the goals, vision, and overall direction of a system designed to care for a population of patients across the care continuum.
• Ability to communicate effectively and professionally, both verbally and in writing.
• Ability to summarize information clearly, thoroughly, and quickly in writing.
• Exceptional diplomacy skills to effectively resolve issues under sometimes tense and stressful circumstances.
• Readily adaptable to the changing needs of the business; able to manage multiple priorities; tolerance for ambiguity.
• Ability to use sound judgement, identify next steps to be taken, and develop appropriate solutions.
• Ability to collaborate with multiple parties to solve problems.
• An eager willingness to learn and grow.

Skills and Education

• Associate Degree or vocational training in a healthcare field preferred.
• Minimum 2 years experience working in a medical practice, hospital, or other healthcare environment preferred.

Benefits                 Competitive benefit package

Hourly Rate                     $26.00

Aspire Health Plan is an equal opportunity employer.

Assigned Work Hours:

M-F, 8-5

Position Type: