Provider Systems Manager
At Performance Health Technology, our people are passionate about what we do and believe that we make a difference in the world of healthcare. Ideas are valued, and quality of life is important--at work and away. Our teams develop inspired and creative solutions for our partners in a culture and environment that lands us in Oregon's 100 Best Companies. If you're looking for a place to bring your very best every day, we'd love to hear from you!
The Provider Systems Manager is primarily responsible for overall management and daily operations of the Provider Systems team in the Provider Services Division. The Provider Systems team is responsible for provider contract management, EDI transactions and second level CIM support. In addition the Provider Systems Manager will give support to the Senior Provider Services Manager with Provider Customer Service, Provider Data Conversion, and other provider services functions.
Essential Duties and Responsibilities
Maintain a technical relationship with multiple clients, external users and providers.
Supervise EDI processes and assist with transferring EDI files between PH Tech and its customer/vendors.
Perform EDI account management responsibilities.
Oversee provider contract management for all PH Tech customers.
Oversee the day-to-day operations for the department.
Manages team to optimize productivity, job satisfaction, and skills development.
Required
Experience:
Education
Type Required/Preferred
High School Diploma Required
Degree in business or related field. Preferred
Experience
Type Required/Preferred
Minimum of three years experience in the health insurance industry - Required
Minimum of two years management/supervisory experience - Required
Minimum of two years customers service experience - Required
Technical Skills Level Required/Preferred
Understanding of claims processing, healthcare insurance, customer service, provider, contracting, and EDI. - Required
Medical terminology, CPT, HCPCS, and ICD-9, ICD-10 coding - Required
Knowledge of data base structures and ability to understand & implement complex system configuration. - Required
Ability to communicate with other technical departments such as SE & BI to improve functionality - RequiredEstimated Salary: $20 to $28 per hour based on qualifications.
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