Location: Dallas, TX
part of a diverse healthcare legacy that’s served our community for more than 125 years. Put your skills to work with us, seek opportunities to learn and join a talented team where patient care is more than a job. It’s our passion. Primary Purpose Responsible for supporting the insurance credentialing process and provider enrollment by ensuring accurate provider information is maintained.
Minimum Specifications Education - High school diploma or equivalent required. - Bachelor¿s degree in business or health-care related discipline preferred. Experience - Two years of experience working in provider enrollment or provider maintenance required. - One year of experience with CAQH, PECOS,
and other provider related databases required. - Experience in a healthcare or managed care field required. Equivalent Education and/or Experience - None Certification/Registration/Licensure - Provider Enrollment Specialist Certification (PESC) preferred.
Skills or Special Abilities - Demonstrated ability to communicate effectively and professionally both verbally and in writing. - Ability to establish and maintain effective working relationships across the organization. - Excellent organizational and time management skills with the ability to handle multiple demands and respond to rapidly changing priorities. - Detail oriented with the ability to thoroughly review information for accuracy.
- Proficient computer and Microsoft Office skills - Understanding of Medicare, State Medicaid, commercial, and managed care health plans.
Responsibilities Responsibilities - Supports the insurance credentialing process by working collaboratively with key stakeholders to ensure provider information is current and accurate. - Assists medical staff and managed contract teams with synchronization of provider data among multiple systems. - Works collaboratively with medical staff and/or managed contracts to resolve issues related to provider information in a timely manner. - Performs Provider enrollment and re-attestation activities for Medicare/Medicaid through the PECOS system.
- Ensures provider profiles, including name changes, practice locations, attestations and any other required payer data are up to date in the appropriate systems and/or databases (i. e. CAQH, PECOS, etc. ). - Participates on special projects or audits as requested. - Assist with data reconciliation as requested. - Displays professional accountability by: Adhering to Parkland Health policies, procedures, and guidelines. Completing assigned training and annual health requirements timely. Recognizing and communicating ethical and legal concerns through the established channels of communication.
Demonstrating accountability and responsibility by independently completing projects and assignments on time and providing timely responses to requests for information. Maintaining confidentiality at all times. Performing other work as requested that is reasonably related to the employee¿s position, qualifications, and competencies. Parkland Health and Hospital System prohibits discrimination based on age (40 or over), race, color, religion, interaction (including pregnancy), interactionual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status.
As part of our commitment to our patients and employees’ wellness, Parkland Health is a tobacco and smoke-free campus. For more details: jobs-search. org/administration_dallas-c448655/provider-maintenance-specialist-dallas_i1971240179
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