Maintain positive public relations with provider groups, hospitals and clinic administrators across all business lines. Act as a personal contact for training, materials distribution, and as an information resource. Work throughout the PacificSource service area to educate provider office staff on current coding and PacificSource administrative and claims procedures. Act as a leading resource for cross functional, complex problem-solving within the Provider Network Department.
Work Experience: 2 years’ experience as a Provider Service Specialist within PacificSource, or 5 years’ experience in related healthcare field.
Education, Certificates, Licenses: High school diploma or equivalent. A CPC or CPC-P certification is recommended.
Knowledge: Excellent written and oral communication, including diplomacy skills for working with the medical professional community as well as the members enrolled in a PacificSource plan. Ability to effectively explain administrative and claims procedures to provider office staff of varying educational backgrounds and familiarity with insurance billing. Basic math skills required, including percentages, ratios, graphing and spreadsheet skills. Ability to read, understand and communicate PacificSource policy. Effective problem solving skills. Ability to read, understand, and communicate provider contractual agreements. Medical terminology proficiency. Experience or education in ICD-10-CM and coding. General computer, word processing and spreadsheet skills. General clerical skills. Ability to remain current on PacificSource administrative and claims procedures, healthcare and the health insurance industry, and claims coding issues. Excellent public relations skills. Ability to prioritize work. Current Oregon driver’s license. Travel throughout the state, generally by automobile, with some overnight visits required.
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 30% of the time.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.