Provider File Maintenance Supervisor in Birmingham

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Job DescriptionJob Description

Provider File Maintenance (PFM) Supervisor

Location: Birmingham, AL

Why VIVA HEALTH?

VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys.

VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare.

Benefits

• Comprehensive Health, Vision, and Dental Coverage
• 401(k) Savings Plan with company match and immediate vesting
• Paid Time Off (PTO)
• 9 Paid Holidays annually plus a Floating Holiday to use as you choose
• Tuition Assistance
• Flexible Spending Accounts
• Healthcare Reimbursement Account
• Paid Parental Leave
• Community Service Time Off
• Life Insurance and Coverage
• Employee Wellness Program
• Training and Development Programs to develop new skills and reach career goals
• Employee Assistance Program

See more about the benefits of working at Viva Health - https://www.vivahealth.com/careers/benefits

Job Description

The Provider File Maintenance (PFM) Supervisor oversees daily operations related to the accuracy, integrity, and timeliness of provider data within PowerSTEPP. This role leads a team responsible for entering and updating provider data to support claims processing, directory accuracy, and network compliance.

Key Responsibilities

• Supervise day-to-day activities of the PFM team to ensure provider information is accurately and timely maintained.
• Monitor and assign workload, set priorities, and ensure turn-around time and quality targets are met.
• Work with provider relations, network development, compliance, credentialing, accounting, and/or claims departments to resolve provider data discrepancies.
• Develop, implement, and maintain procedures related to provider file maintenance.
• Train, coach, and mentor staff to promote excellent performance and growth.
• Generate and analyze reports on team performance, error rates, and turnaround times.
• Responsible for notifying all departments about known provider changes.
• Review work processes to identify opportunities and implement improvements for handling or maintaining provider information.
• Work cohesively with Configuration staff to ensure providers are configured appropriately for accurate claims payment.

REQUIRED QUALIFICATIONS:

• High School Diploma or GED
• At least 3 – 5 years’ experience in a managerial or supervisory role
• At least 3 – 5 years’ experience with managed care and current core computer system
• Excellent written and verbal communication skills
• Detail-oriented with excellent problem-solving skills
• Ability to multi-task and supervise multiple projects simultaneously
• Ability to interact with all departments and levels of management in a professional manner

QUALIFICATIONS:

• Bachelor's degree
• Experience in PowerSTEPP
• Proficient in the Microsoft Office suite of products

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