Provider Portal Specialist
3 days ago
Pasadena
Job Description Job Description: Web Portal Specialist Department: EDI/Eligibility/Provider Portal Reports To: Senior Manager, EDI/Eligibility/Provider Portal Position Type: Full-Time (1st Shift; 8 hours/day, 5 days/week; callback as needed) Position Summary The Web Portal Specialist plays a critical role in supporting Imperial’s digital operations by managing and optimizing the organization’s provider-facing online systems, including the EZ-NET and EZCAP web portals. This position ensures a seamless, secure, and high-quality user experience for external providers, vendors, IPAs, and internal business units. The Web Portal Lead is responsible for overseeing account administration, portal functionality, user support, and compliance with HIPAA and organizational security protocols. As a key member of the EDI operational team, this role collaborates closely with Provider Network, Provider Data Management, IT, Compliance, and other cross-functional units to maintain accurate access controls, streamline registration workflows, and enhance portal usability. The Web Portal Lead is also responsible for identifying process gaps, proposing system improvements, and ensuring that Imperial’s web portal presence reflects both regulatory requirements and operational best practices. Scope of Responsibility • Maintain positive and professional relationships with all portal users across external and internal stakeholders., • Ensure alignment of web portal configurations with vendor-provided Tax Identification Numbers (TINs), organizational access policies, and HIPAA requirements., • Support Imperial’s strategic initiatives by ensuring that the provider portal is accessible, intuitive, and aligned with company branding, operational objectives, and customer service standards., • Serve as a subject matter expert (SME) for all EZ-NET and EZCAP portal functionalities and workflows., • Provide guidance and operational support to internal teams regarding portal access, account structures, and delegated entity configurations. Key Responsibilities Portal Administration & Account Management • Oversee the full lifecycle of EZ-NET account creation, configuration, maintenance, and termination for external providers, vendors, and IPAs., • Ensure that all portal access aligns with internal security standards, vendor-provided TINs, and HIPAA privacy guidelines., • Monitor system user activity for irregularities, security risks, or access discrepancies; escalate issues when necessary., • Maintain accurate records and audit trails of user account setup, changes, and access removal., • Coordinate with Provider Network and Provider Data Management teams to validate credentialing status, contracting details, and provider affiliations impacting portal access. User Support & Communication • Monitor the Provider Portal inbox for EZ-NET registrations, inquiries, and operational requests., • Provide tier-1 and tier-2 support for EZ-NET call queues, responding to both internal and external inquiries., • Troubleshoot access issues, password resets, provider data display problems, and system errors., • Deliver clear, professional, and timely communication to portal users, ensuring exceptional service and quick issue resolution., • Conduct periodic outreach to providers or delegated entities to validate portal contacts and ensure user lists remain current. System Oversight & Operational Efficiency • Serve as the primary operational liaison with IT regarding system enhancements, access issues, defect reporting, and change requests., • Participate in user acceptance testing (UAT) for portal upgrades, configuration changes, and system fixes., • Develop and maintain standard operating procedures (SOPs), job aids, workflow documentation, and training materials for portal access and user functionality., • Identify opportunities to improve portal usability and optimize operational workflows; provide data-driven recommendations., • Ensure portal configuration aligns with changing organizational requirements, new provider groups, vendor onboarding, and system integrations. Compliance & Risk Management • Ensure ongoing compliance with HIPAA, HITECH, and internal data security protocols for all portal interactions., • Conduct regular audits of user access to verify appropriate permissions and remove or update accounts as needed., • Support internal and external audits by providing documentation, logs, and clarification regarding access management., • Collaborate with Compliance and Security teams on incident tracking, mitigation, and root-cause analysis related to portal access. Cross-Functional Collaboration • Work closely with EDI, Eligibility, Provider Data Management, Provider Network, Claims, and IT to support operational readiness and address systemic issues., • Participate in cross-departmental meetings to represent portal operational needs and user experience considerations., • Support organizational initiatives and business requirements tied to provider engagement, operational analytics, and digital transformation. Reporting & Metrics • Track and report on key performance indicators (KPIs), including: o Portal registration volumes o Account creation/closure trends o Helpdesk response times o User access compliance o Issue resolution metrics • Provide weekly, monthly, or ad-hoc reports to leadership as required. Minimum Qualifications Education & Experience • High School Diploma or GED required; Associate’s or Bachelor’s Degree in Business Administration, Healthcare Administration, Information Systems, or related field preferred., • 3+ years of experience in healthcare operations, health plan administration, provider relations, or related environments., • 2+ years of experience managing user accounts or portal systems (EZ-NET, EZCAP, or similar provider-facing applications strongly preferred)., • Experience with HIPAA regulations, PHI handling, and healthcare data security best practices. Knowledge & Technical Skills • Working knowledge of: o Provider contracting structures o Provider data management workflows o Health plan operations (eligibility, claims, authorizations) o Delegated entity oversight • Understanding of EDI workflows (e.g., 834/837/270/271) preferred., • Proficiency with Windows, Microsoft Office Suite, and ticketing systems (e.g., ServiceNow, Jira, or similar)., • Ability to interpret TIN information and apply correct access logic for provider groups, vendors, and IPAs., • Familiarity with user provisioning, role-based access, and security permission models. Skills & Competencies • Strong analytical and problem-solving abilities with exceptional attention to detail., • Excellent written and verbal communication skills, with the ability to interact effectively at all organizational levels., • Ability to prioritize and manage multiple tasks in a fast-paced environment., • Commitment to confidentiality and data protection., • Strong customer service orientation with a professional and courteous demeanor., • Ability to work independently with minimal supervision while managing complex workflows. Additional Preferred Qualifications • Experience supporting provider-facing technologies within a managed care organization or health plan., • Knowledge of EZCAP/EZ-NET configuration tools, roles, permissions, and backend settings., • Prior involvement in system implementation and/or UAT testing, • Understanding of healthcare compliance frameworks and reporting standards.