Provider Data Management (PDM) Support Specialist

TRILLIUM HEALTH RESOURCES

10h • Remote

About The Position

Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives.

Trillium Health Resources has a career opening for a Provider Data Management (PDM) Support Specialist to join our team! The PDM Support Specialist is responsible for providing guidance and support to the PDM Unit. The PDM Unit is responsible and focused on the management of Provider Data. This includes processing daily provider data, monitoring the Provider Enrollment File (PEF), conducting crosswalk analyses between the Provider Electronic Data (PED), PEF, NC Tracks, other state systems, and information located in Trillium Business Systems (TBS), reconciling data inaccuracies, mapping provider data, identifying trends and patterns in data, auditing data, adhering to reporting requirements and conducting provider outreach and technical assistance. The PDM Unit is responsible for reducing provider data errors in reporting and ensuring that provider data on the PEF and in TBS are aligned.

Requirements

• High school diploma or GED and a minimum of one (1) year credentialing and/or healthcare record management or medical billing experience required, OR Equivalent combination of higher education/experience.
• Must have a valid driver’s license
• Must reside within North Carolina
• Must be able to travel within catchment as required.

Nice To Haves

• Associates degree
• Experience in medical office management and medical terminology training.

Responsibilities

• Process confidential and complex information with discretion and professionalism.
• Prepare, process, and review oral and written material.
• Review provider data information received on the Provider Enrollment File (PEF) or as loaded in NC Tracks for accuracy and completeness and make corrections as required.
• Ensure accurate and timely completion of provider demographic data entry.
• Review PEF change report daily to ensure consistent information and make corrections as required.
• Receive and process correspondence from internal staff and external Providers with promptness.
• Provide prompt technical assistance and support for both in-network providers and community stakeholders, as needed.

Benefits

• Typical working hours: 8:30 am – 5:00 pm; flexible work schedules with some roles with management approval.
• Work-from-home options available for most positions
• Health Insurance with no premium for employee coverage
• Flexible Spending Accounts
• 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year
• NC Local Government Retirement Pension (defined-benefit plan)
• 401k with 5% employer match and immediate vesting
• Public Service Loan Forgiveness (PSLF) qualifying employer
• Quarterly stipend for remote work supplies

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 251-500 employees