• To assist Provider Services and Network Development staff in the development and maintenance of the provider network.
• Responsible for provider’s demographic changes including updating the Diamond system and preparation of LibertyNet break sheets to IT for loading. Routing these changes to Provider Services Data Administrator for updating the ppoONE system.
• Open and review correspondence from providers. Review and route to proper BFH departments for resolution. Also follow up with department if necessary
• In conjunction with the PS Specialist, will handle provider contacts via phone.
• Address claims assigned to Specialist from claims queue on a daily basis.
• Copy and Log all new credentialing data and route to Credentialing Department in a timely manner ensuring all data requested is attached.
• Retrieve, log and route contracts to proper BFH department functions when returned by provider.
• Will be assigned additional projects as they occur concerning provider data such as mailings, directories, etc…

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed 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. Must be dependable, self directed, organized, detail – oriented, flexible and a team player. Must possess ability to make decisions. Should be friendly, enthusiastic, professional person who is capable of working independently. Maintain a working knowledge of Microsoft Word, Excel, Access and Diamond. Results oriented and ability to prioritize and manage workload.

• The Provider Services Specialist will be primarily responsible for recruiting, contracting and servicing providers/or coordinating such activities with BFH participating IPA's/PPO's within the Specialist's assigned territory.
• Conduct on-site meetings with each participating provider consistent with established servicing guidelines and to educate appropriate staff members about BFH policies and requirements.
• Serve as liaison between BFH and participating providers on new and changing BFH initatives, policies /procedures and other requirements.
• Facilitate the contracting process with participating providers including new and renewal agreements.

Must possess the following traits: dependable, self-directed, organized, detail oriented, flexible, team player and maintain confidentiality. Must maintain a working knowledge of Microsoft Word, Excel, Access and Diamond.

The following are required: High school diploma and 2 years experience in data entry, data processing; 2 years experience in system configuration, Advanced ability in Microsoft Excel, experience in writing Access or SQL queries.