Provider Services Coordinator

Provider Services CoordinatorThis 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.Education and ExperienceAssociate's degree or equivalent combination of education, training, and experience required.Minimum of two years of experience in healthcare or financial data processing preferred.SkillsIntermediate 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.KnowledgeBasic 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.AbilitiesDemonstrated 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.Essential FunctionsProvider Director MaintenanceReceive, 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 & ValidationsFacilitate 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 ImprovementDeliver 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 FunctionsAdhere to work performance norms and attendance expectations.Perform other duties as assigned.Physical RequirementsActivity/Physical Function - Seldom(0%-5%) - Occasional(6% - 33%) - Frequent(34% - 67%) - Constant(>67%)Operate Office Equipment(Repetitive Motion) - XRemain in Stationary Position - XMove/Traverse - XCommunicate, Detect, Discern,and/or Convey - XObserve, Identify, Distinguish,Recognize, Inspect and/or Compare - XMove up to 20 lbs. - XMove 21 to 50 lbs. - XMove over 50 lbs. - XPushing and/or Pulling - XAscend/Descend, Position Self, and/or Move to Accommodate High and/or Low Positions - XEnvironmental ConditionsExposure to Environmental Conditions - Seldom(0%-5%) - Occasional(6% - 33%) - Frequent(34% - 67%) - Constant(>67%)High Temperatures (over 85) - XModerate Temperatures (60 80) - XLow Temperatures (under 50) - XWet and/or High Humidity - XSudden Temperature Changes - XNoise High Level - XNoise Vibrations - XHazards Mechanical & Electrical - XFumes/Odors/Smoke/Gas - XThe Health Plan of San Mateo (HPSM) is an equal opportunity employer and is committed to providing equal employment opportunities to all applicants and employees without regard to race, color, religion, creed, political affiliation, sex, gender, gender identity or expression, pregnancy, childbirth and related medical conditions, marital status, registered domestic partner status, sexual orientation, age, ancestry, national origin, citizenship status, veteran or military status, disability, medical condition, genetic information, or any other characteristic protected by applicable federal, state, or local law.This policy applies to all aspects of employment, including recruitment, hiring, selection, placement, promotion, transfer, demotion, compensation, benefits, training, discipline, and termination.HPSM is committed to providing reasonable accommodations to qualified individuals with disabilities and to applicants and employees with sincerely held religious beliefs or practices, in accordance with applicable law. If you require an accommodation during the application or interview process, or in order to perform the essential functions of a position, please contact the HPSM recruiter to request assistance.