Under the direction of the manager, the Provider Data Specialist is responsible for maintaining accuracy of provider data in both internal and external databases. This position is expected to work effectively with internal and external contacts in an effort to meet all regulatory and industry provider data quality and accuracy standards. This position performs a variety of administrative and managed care contract support functions to ensure health plan requirements for provider enrollment and reimbursement are identified, communicated and coordinated both internally and with Phoenix Children's Medical Group contracted health plans.
Under general supervision of the Transplant Financial Services Manager, this position serves as a liaison between hospital, patient and third-party payors for all financial matters is secures all necessary authorizations to ensure transplant related services are approved by any third-party payors before proceeding with treatment. This position also ensures the patient/family has a thorough understanding of the transplant benefits available to them and any coverage restrictions before a transplant is undertaken.