Provider Information Management (PIM) Coord

Prospect Medical Holdings Incorporated

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The Provider Information Coordinator is responsible for submission of data provided to the health plan, quality assurance of rosters and identifying trends. In addition to assisting in educating the staff on improvements and updates of health plans.

Responsible for timely and accurate processing of provider change forms.jobs-near-me.orgResponsible for the submissions to contracted health plans for applicable network.jobs-near-me.orgResponsible for provider listing maintenance and follow-up with health plans to ensure that all submissions have been processed appropriately.jobs-near-me.orgAudit new employees work prior to submission to health plans within thirty (30) days of training.jobs-near-me.orgReview Change Form on CDA, Morrisey reports, emails submitted to health plans. Review PID retrieval and resubmission process.Quality review of rosters submitted to health plans.jobs-near-me.orgAssists in educating and updating the PIM/Credentialing Department on new guidelines.jobs-near-me.orgResource for training, education and coordination of improvements and additions. Weekly review of reports to identify areas for training.jobs-near-me.orgIdentify trends and report to management.

Five (5) years’ experience and/or training in credentialing and/or contracting in a hospital or IPA setting. High school diploma or GEDBachelors in Business Administration or equivalent from a four year college or technical school preferred.

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