Provider Services Coordinator

Provider Services Coordinator Health Plan of San Mateo

• 3.4 South San Francisco, CA Job Details Full-time $26.57
• $33.

59 an hour 15 hours ago Qualifications Financial data reconciliation Automation Financial transaction processing Data analysis skills Process improvement Mid-level Improving operational efficiency Customer inquiry handling Data quality management Task prioritization Data entry Productivity software HP Service Manager Data validation Associate's degree Escalation handling 2 years Communication skills Stakeholder relationship building Full Job Description General Description This role will be responsible for processing provider Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) requests and coordinating HPSM Provider Directory Updates with a special focus on data intake, data entry, and data validation. The Provider Services Coordinator will validate sensitive financial information, identify potential risk factors, and ensure accuracy and compliance in provider financial data Qualifications The following represents the typical way to achieve the necessary skills, knowledge and ability to qualify for this position: Education and Experience Associate's degree or equivalent combination of education, training, and experience required. Minimum of two years of experience in healthcare or financial data processing preferred. Skills Intermediate proficiency in Microsoft Office Suite applications. Intermediate data analysis and reconciliation skills. Advanced data entry and maintenance skills with high attention to accuracy. Advanced written and verbal communication skills. Knowledge Basic knowledge of provider payment processing preferred. Basic knowledge of provider directories or provider network data preferred. Working knowledge of principles related to data security, integrity, and validation. Abilities Demonstrated ability to maintain accuracy and effectively prioritize tasks. Demonstrated ability to analyze and reconcile data discrepancies. Ability to exercise discretion when handling sensitive financial and provider data. Ability to process and update provider data changes accurately and in a timely manner. Ability to build and maintain collaborative relationships across departments and with providers. Licensure/Certifications Not Applicable. Driving Not Applicable. Duties & Responsibilities Essential Functions Provider Director Maintenance Receive, review, and process provider demographic change requests. Perform outreach to provider offices to verify information accuracy and completeness, ensuring timely updates in the system of record. Respond to provider calls and inquiries regarding a variety of needs in a timely manner. Work closely with internal teams to ensure provider data is reflected accurately. EFT/ERA Processing &Validations Facilitate the intake and verification of EFT/ERA requests from providers. Validate banking and remittance information for providers. Act as the main contact for resolving EFT/ERA issues and guiding providers. Training & Process Improvement Deliver hands-on support to providers navigating HPSM's provider portal, including assistance with EFT/ERA submissions and demographic updates. Escalate complex issues and maintain a high level of customer service and professionalism. Identify recurring issues or inefficiencies in workflows and recommend improvements. Support provider data integrity initiatives and automation improvements. Maintain up-to-date documentation of procedures, templates, and FAQs. Secondary Functions Adhere to work performance norms and attendance expectations. Perform other duties as assigned. Physical Requirements Activity/Physical Function Seldom (0

• 5%) Occasional (6%
• 33%) Frequent (34%
• 67%) Constant ( >67%) Operate Office Equipment (Repetitive Motion) X Remain in Stationary Position X Move/Traverse X Communicate, Detect, Discern, and/or Convey X Observe, Identify, Distinguish, Recognize, Inspect and/or Compare X Move up to 20 lbs.

X Move 21 to 50 lbs. X Move over 50 lbs. X Pushing and/or Pulling X Ascend/Descend, Position Self, and/or Move to Accommodate High and/or Low Positions X Environmental Conditions Exposure to Environmental Conditions Seldom (0

• 5%) Occasional (6%
• 33%) Frequent (34%
• 67%) Constant ( >67%) High Temperatures (over 85°) X Moderate Temperatures (60°
• 80°) X Low Temperatures (under 50°) X Wet and/or High Humidity X Sudden Temperature Changes X Noise
• High Level X Noise
• Vibrations X Hazards
• Mechanical & Electrical X Fumes/Odors/Smoke/Gas X