Provider File Maintenance Specialist

Provider File Maintenance (PFM) Specialist Location: Birmingham, AL Work Schedule: Mostly Remote - after an onsite training period at our downtown Birmingham office, this position can transition to work mostly remote, with occasional onsite days. The successful candidate must reside within a reasonable travel distance of Birmingham. Why VIVA HEALTH? VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys. VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare. Benefits Comprehensive Health, Vision, and Dental Coverage 401(k) Savings Plan with company match and immediate vesting Paid Time Off (PTO) 9 Paid Holidays annually plus a Floating Holiday to use as you choose Tuition Assistance Flexible Spending Accounts Healthcare Reimbursement Account Paid Parental Leave Community Service Time Off Life Insurance and Disability Coverage Employee Wellness Program Training and Development Programs to develop new skills and reach career goals Employee Assistance Program See more about the benefits of working at Viva Health - https://www.vivahealth.com/careers/benefits Job Description The Provider File Maintenance (PFM) Specialist is responsible for maintaining accurate provider demographic, payment, and contractual information in VIVA HEALTH’S claims processing system. Key Responsibilities Enter and update providers in VIVA HEALTH’S claims processing system. Verify integrity of data by comparing it to source documents. Review input data for errors or missing information and resolves any discrepancies. Monitor and maintain Medicare opted-out providers and Medicare precluded providers. Communicate terminated and reinstated providers to all areas of VIVA HEALTH. Perform fee schedule maintenance in the claims processing system. Support the configuration team, as needed, in maintaining system reference files. REQUIRED QUALIFICATIONS : High School Diploma or GED Healthcare industry knowledge Ability to work under pressure to meet deadlines with minimal supervision Demonstrate excellent customer service skills through written and verbal communication Ability to produce quality-focused work Ability to work independently and as a member of a team Basic computer skills PREFERRED QUALIFICATIONS: Some College Claims processing and/or provider credentialing/contracting knowledge 2 – 3 years’ experience with PowerSTEPP Proficient knowledge of Microsoft Excel and Microsoft Outlook