Providence Health & Services Provider Data Specialist in Salem, Oregon
Providence St. Joseph Health is calling a Provider Data Specialist to our location in Salem, OR.
We are seeking a Provider Data Specialist who will be primarily responsible for the management of provider contracts. This position will act as the main contact for contracting, contracting questions, education as well as act as a liaison between the provider, health plan and PH TECH.
The Provider Data Specialist will provide EDI support, data importing and EDI testing and provider customer service.
In this position you will have the following responsibilities:
Maintain a technical relationship with multiple clients, external users and providers. Also serve as back-up phone support for CIM Support incoming calls.
Register external users to CIM.
Logging calls and helping users/callers through basic and advanced troubleshooting steps.
Distributing incident to high level support staff if necessary.
Following up with the caller when the incident is resolved.
Perform PH TECH system training on an as-needed basis for external customers.
Perform system and process testing for deployment of changes and updates to software.
Support EDI processes and assist with transferring EDI files between PH TECH and its customers/vendors. Performs some EDI account management responsibilities.
Provide technical expertise and support to manage daily EDI transactions.
Maintain and manage submitter checklists.
Test, implement and maintain EDI transactions new and current trading partners.
Analyze, design and develop specifications for enhancements and extensions to electronic data interchange application interfaces and maps.
Help maintain best practices of network security and data protection.
Evaluate current EDI process and recommend efficiency and cost improvement options.
Manage business relationship with industry trading partners.
Transaction and file research.
Provider Contract Management & Oversight
Maintain and document provider contracts in CIM.
Ensure contracts are current and compliant with all Medicare and Medicaid requirements.
Facilitate loading of contracted providers in a timely manner between PH TECH and Health Plans.
Create and maintain reporting to support internal processes and client requests.
Assist other departments and positions with provider contract renewals. Communicate with management to implement new provider fee schedules.
Required qualifications for this position include:
High School Diploma or GED.
2 years healthcare administration experience (claims, customer service, provider relations, or other).
Preferred qualifications for this position include:
- 3 years claims processing experience.
About Providence in Oregon.
As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities. The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple, "Providence will provide the best care and service to every person, every time."
Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.
We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Billing/Insurance
Req ID: 296693