Job Information

Providence Operations Support Specialist 1 in Beaverton, Oregon

Description

Providence Health Plan is calling an Operations Support Specialist 1 to our location in Beaverton, OR. This role will be on-site 100% . Qualified candidates need to be a commutable distance to the office location.

We are seeking an Operations Support Specialist 1 who will be responsible for providing support for the Health Plan Operations department in the key areas of:

  • Imaging/Scanning of claims and documents.

  • Entry of claims data.

The Support Specialist must perform all duties in a manner that complies with the accuracy and efficiency standards established by management, as well as possess the collaborative skills necessary to perform within a team environment.

MAJOR CHALLENGES

  1. Maintain a high level of productivity to meet performance standards.

  2. Ability to work large volumes of claims/documents on a daily basis with a high level of accuracy.

  3. Ability to maintain attention to detail with repetitive tasks in a fast paced production environment.

  4. Handle multiple priorities effectively.

  5. This position requires sitting at a computer or scanner for most of the work day.

  6. Keep up-to-date on the frequent changes in documentation and how those changes affect the work we do.

  7. Demonstrate the flexibility to adjust the workload or work hours as required.

  8. Familiarize self with all the different departments and teams.

  9. Thrive in a team environment with a wide variety of people with shared accountability in a constructive, professional manner.

  10. Ability to communicate with internal customers in a professional, respectful, and courteous manner.

In this position you will have the following responsibilities:

  • Scanning/Imaging:

  • Sort, batch, and index all paper claims and other documents within guidelines.

  • Monitor scanning equipment for enhancement adjustments, sensitivity, and regulate scanner to ensure clarity of documents and keep rescans to a minimum.

  • File and maintain scanned documents for 30 days.

  • Handle incoming mail and faxes. Direct correspondence to the appropriate department when necessary.

  • Index documents to the appropriate member/provider.

  • Investigate member ID information, and either correct ID numbers or return claims to providers when necessary.

  • Edit member and provider ID numbers on claims in Facets.

  • Data Entry:

  • Analyze and input claim information from medical, hospital, vision providers, Home Services, Home Health, Home Infusion, and all miscellaneous claim types into the computer system.

  • Check data for accuracy and make corrections as necessary.

  • Verify member and physician/provider identification, diagnosis, CPT/ICD-9 codes, dates of service, location code, modifiers, units, NDC codes, patient accounts, and charges as needed.

  • Maintain production standards as determined by management.

  • Meet team standards of quality with 95% or better accuracy.

  • Miscellaneous:

  • Read and interpret online documentation, and identify areas of need and improvement.

  • Participate in team member reviews.

  • Accept work assignments to meet the needs of the team as assigned by supervisor. Possess an ability to be flexible in a team environment having multiple responsibilities.

  • Participate in team meetings including: facilitating and/or taking minutes, giving reflections and communicating minutes to the team.

  • Demonstrate a consistent, dependable work effort and a positive work attitude.

  • Aid in prioritizing individual workload to meet deadlines, fluctuations in claims, volume, and rapidly changing priorities.

  • Basic awareness of quality improvement initiatives.

  • Adherence to the BRITE standards (Behaviors Resulting in Team Excellence).

  • Utilize solid judgment and adhere to all policies ensuring the protection of confidential information related to patient demographics, medical information, diagnosis codes, etc., according to internal and federal HIPAA regulations.

  • Maintain respectful, professional behavior during all trainings and meetings.

Required qualifications for this position include:

  • 6 months experience using a personal computer, data entry operations or 10-key by touch

  • Experience working on a PC in the Windows environment

Preferred qualifications for this position include:

  • Work experience in medical insurance and knowledge of medical terminology and CPT/ICD-9

About Providence in Oregon

As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.

The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,

"Providence will provide the best care and service to every person, every time."

Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.

We offer a full comprehensive range of benefits — see our website for details —http://www.providenceiscalling.jobs/rewards-benefits

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Requsition ID: P359711
Company: Providence Jobs
Job Category: Member Services Enrollment & Billing
Job Function: Health Plans Services
Schedule: Full time
Shift: Day
Career Track: Admin Support
Department: 5018 OPS CLAIMS ENTRY OR REGION
Address: OR Beaverton 3601 SW Murray Blvd

Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.