AIDS Healthcare Foundation

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Provider Relations Data Entry Clerk

Provider Relations Data Entry Clerk

Req No 
2017-7224
Job Locations 
US-CA-Los Angeles
Category 
Managed Care
Type 
Regular Full-Time

More information about this job

WHO WE ARE

Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?


If so, AIDS Healthcare Foundation is the place for you!

Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the world. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.

AHF’s Core Values

• Patient-Centered
• Value Employees
• Respect for Diversity
• Nimble
• Fight for What’s Right

 

Benefits at AHF
AHF offers comprehensive benefits to help our employees do and be their very best! These benefits are intended to enhance employee physical, financial, spiritual, and professional health.

 

The Provider Relations Coordinator is responsible for projecting and integrating the Mission and Core Values of the organization within and outside of the Managed Care Department.

 

Essential Duties & Responsibilities

Includes the following.  Other duties may be assigned.

 

  • Support efforts of Provider Relations and Credentialing by ensuring accurate and complete Provider demographics, including all information needed for the acceptance of encounters, provider network files, and enrollment files by AHCA, CMS and DMHC.
  • Responsible for entering initial credentialing, demographic and contract information in PHP/PHC MIS system for delegated provider groups and non-contracted providers.

Responsible for accuracy and completeness of provider information in PHP/PHC MIS system by tracking terminations and additions to provider network and remediating or completing any information nee

  • affiliates.
  • Responsible for working with MIS departments on monthly update of provider network files on websites in compliance with CMS and AHCA.
  • Responsible for maintaining current provider files, including incoming/outgoing correspondence.
  • Compares data entered with source documents and re-enters data
  • Makes necessary corrections to information entered
  • Compiles sorts and verifies accuracy of data to be entered
  • Keeps record of work completed
  • Files source documents after entry
  • Responds to inquiries regarding entered data

Participation in AHF Meetings/Committees

Managed Care Staff Meeting

Weekly Provider Relations Meeting

Various Provider Relations training and staff meetings

Other meetings/committees as assigned

 

Supervisory Responsibilities

This job has no supervisory responsibilities.

YOUR CONTRIBUTION TO OUR SUCCESS!

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.    The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


Education and/or Experience

Associate’s degree (A.A.) or relevant experience in data management and customer service.

Computer/Software Skills & Abilities

To perform this job successfully, an individual should have knowledge of MS Office programs as well as experience with health plan MIS systems

Language Skills

Ability to read, analyze, and interpret spreadsheets including member and provider demographic information.  Ability to effectively communicate and present information to PR, MIS and enrollment departments.

 

Mathematical Skills

Intermediate Skills

 

Reasoning Ability

Very High Skills:  Ability to define problems, collect data, establish facts, and draw valid conclusions.  Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.

Other Skills & Abilities/Qualifications

  • Ability to summarize analytical results in Crystal Reports, MS Excel, PowerPoint, etc.   
  • Proficient and demonstrated use of database reporting tools for data manipulation, data extraction, merging of large, complex data from variety of sources.
  • Prior experience with health-related databases and electronic medical records systems preferred.
  • Typing:  50 words per minute (minimum)
  • Provider claim processing knowledge and/or experience is preferred.

We at AIDS Healthcare Foundation believe that each individual is entitled to equal employment opportunities without regard to race, color, creed, gender, sexual orientation, gender identity, marital status, national origin, age, veteran status or disability. The right of equal employment opportunity extends to recruiting, hiring selection, transfer, promotion, training and all other conditions of employment.