- Be required understanding of managed care systems and the importance of member eligibility / benefits as the foundation of the process.
- Have effective communication skills and a working knowledge of managed care and health plan contracts are critical as are good judgment and decision-making skills.
- Have strong interpersonal relations and team building skills are a requirement for internal and external purposes. Experience in managed care and processing enrollment is important
- Support the values of PH&S-CA and proven ability to use team concepts to enhance shared leadership philosophies are essential for the success of this position.
- Responsible for processing member eligibility and benefits.
Required qualifications for this position include:
- Bachelor's Degree in Health Administration, business administration or an equivalent area.
- Must understand data processing policies and procedures related to entering, updating, and maintaining patient enrollment information, including knowledge of Health Plan's.
- Must possess excellent problem solving abilities and demonstrate skills with investigating and researching enrollment discrepancies.
- Must be proficient in the Enrollment module of the GE/IDX system.
Preferred qualifications for this position include:
- Knowledge in Microsoft Applications, including a strong understanding of MS Excel and MS Access.
- Able to work collaboratively with other operational units within Providence Health & Services.
- Able to work independently and complete assigned tasks without constant supervision.
- Able to perform at high level in an environment of rapid growth, constant change and sometimes ambiguous circumstances.
About the location you will serve:
Providence Health & Services Southern California is further developing its physician integration strategy. Historically, the largest asset has been Providence Medical Institute, a medical foundation that provides administrative and other support services to affiliated medical groups. Providence Medical Institute is expected to grow significantly in the next several years, bringing with it facilities, staff and physician growth to support that objective.